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October 12, 2011

BehindTheMedspeak: Burned by water-skis on fire? There's a code for that.


From Anna Wilde Mathews' September 13, 2011 Wall Street Journal front page story: "Today, hospitals and doctors use a system of about 18,000 codes to describe medical services in bills they send to insurers. Apparently, that doesn't allow for quite enough nuance.

"A new federally mandated version will expand the number to around 140,000 — adding codes that describe precisely what bone was broken, or which artery is receiving a stent.

"It will also have a code for recording that a patient's injury occurred in a chicken coop."


More excerpts from the WSJ article follow.

The federal agencies that developed the system — generally known as ICD-10, for International Classification of Diseases, 10th Revision — say the codes will provide a more exact and up-to-date accounting of diagnoses and hospital inpatient procedures, which could improve payment strategies and care guidelines. "It's for accuracy of data and quality of care," says Pat Brooks, senior technical adviser at the Centers for Medicare and Medicaid Services.

Billing experts who translate doctors' work into codes are gearing up to start using the new system in two years. They say the new detail is welcome in many cases. But a few aspects are also causing some head scratching.

Some codes could seem downright insulting: R46.1 is "bizarre personal appearance (see code)," while R46.0 is "very low level of personal hygiene (see code)."

It's not clear how many klutzes want to notify their insurers that a doctor visit was a W22.02XA, "walked into lamppost, initial encounter" (or, for that matter, a W22.02XD, "walked into lamppost, subsequent encounter").

Why are there codes for injuries received while sewing, ironing, playing a brass instrument, crocheting, doing handcrafts, or knitting — but not while shopping, wonders Rhonda Buckholtz, who does ICD-10 training for the American Academy of Professional Coders, a credentialing organization.

Code V91.07XA, which involves a "burn due to water-skis on fire (see codes)," is another mystery she ponders: "Is it work-related?" she asks. "Is it a trick skier jumping through hoops of fire? How does it happen?"

The WHO, for instance, didn't see the need for 72 codes about injuries tied to birds. But American doctors whose patients run afoul of a duck (see codes), macaw (see codes), parrot (see codes), goose (see codes), turkey (see codes) or chicken (see codes) will be able to select from nine codes for each animal, notes George Alex, an official at the Advisory Board Co., a health-care research firm.

There are 312 animal codes in all, he says, compared to nine in the international version. There are separate codes for "bitten by turtle" and "struck by turtle." (See codes.)

With the move to ICD-10, the one code for suturing an artery will become 195 codes, designating every single artery, among other variables, according to OptumInsight, a unit of UnitedHealth Group Inc. A single code for a badly healed fracture could now translate to 2,595 different codes, the firm calculates. Each signals information including what bone was broken, as well as which side of the body it was on.

October 12, 2011 at 04:01 PM | Permalink | Comments (3) | TrackBack

Miniature Stapler


I decided to get a tiny stapler and figured it would be the old red version from Swingline called the "Tot."

I got the name right but that's about it.


Seems like in the decades since I last bought one, they've completely redesigned it as well as tricking it out with added features while selling it for less than I recall paying in the dimly remembered days of the late twentieth century.

Now it's all swoopy and angled like the BMW Z4 and they've added an integrated staple remover and a storage compartment on the bottom, ostensibly for spare staples but you could think outside the office supplies box if you were so inclined.

Mine measures 2.5"L x 1.25"W x 1.5"H.



October 12, 2011 at 03:01 PM | Permalink | Comments (4) | TrackBack

The science of great structures

Wrote Bill Gates on his blog:

Recently I watched "Understanding the World's Greatest Structures," taught by Stephen Ressler, and I thought it was fascinating.

Professor Ressler does a great job explaining the basic elements of structures in 24 lectures of 30 minutes each. After the introductory lecture, he uses the next eight to explain the key elements of structure — cables, beams, columns, arches and trusses. The examples and demonstrations are amazingly good. He keeps things interesting at every step.

The rest of the course covers the history of different types of structures. You learn about bridges that collapsed, like the Tacoma Narrows bridge in Washington State, and how engineers have learned from mistakes. The world has many more amazing and beautiful structures than I appreciated. Ressler shows dozens of bridges and buildings that use novel structural approaches, which are quite amazing.

I loved this course. Ressler's enthusiasm for the topic comes through in every lecture. It's possible that the audience for this course isn’t large — perhaps not many other people have thought about why buildings don't fall down. But it you are at all tempted, I encourage you to watch it.

Worth noting: it's not just Bill Gates who thinks the course is outstanding — the average customer rating for the course is 5 out of 5 stars and "55 of 55 customers would recommend the course to a friend."

October 12, 2011 at 02:01 PM | Permalink | Comments (0) | TrackBack

What is it?


Answer here this time tomorrow.

Hint: not edible.

Another: smaller than a bread box.

October 12, 2011 at 01:01 PM | Permalink | Comments (6) | TrackBack

A decade of data breaches


Wrote Mark Fischetti in the October issue of Scientific American, "We are constantly warned to protect our passwords, Social Security numbers and other 'personal identifying information' to thwart thieves who may steal laptops or perpetrate online fraud. Although such breaches have soared since 2005 (bar graph above) as criminals try to committ identity theft, the truly enormous breaches (circles above) have increasingly been carried out by 'hacktivists' — individuals or groups who are angry about an organization's actions. Hackers, for example, exposed data about 77 million Sony customers after the company pursued legal action against other hackers. 'More than 107 million people were affected by hacking during the first half of 2011,' says Jake Kouns, CEO of the Open Security Foundation in Glen Allen, Virginia, which runs the DataLossDB project (the data source for the graphics above)."

"Will you be informed if your data are exposed? Maybe not. Congress is considering bills that would require companies to notify customers of breaches only if there was a 'reasonable risk' that personal information was taken. Right now many states require companies to disclose all breaches."

October 12, 2011 at 12:01 PM | Permalink | Comments (1) | TrackBack

Do-All Outdoors Pee Pee Bottle


From the website:


Do-All Outdoors Pee Pee Bottle does exactly what it sounds like it does — it's a portable outdoor bathroom that fits in your pack.

You can't afford to leave your tree stand just to use the bathroom while hunting, and peeing over the side can alert game to your presence by smell alone.

The Do-All Bottle provides the answer when nature calls.

Simply unscrew the lid of this hunting accessory, relieve yourself, and resume your vigil in peace.

Up to 26 ounces of urine can fit in the bottle, enough to keep your bladder happy for the extent of any hunting trip.

Two screw-in mounting rings [below]

Screen Shot 2011-10-12 at 11.10.25 AM

are included, allowing you to mount the bottle to your tree without any tools, so you don't have to worry about a bottle full of pee rolling around your tree stand and possibly bursting open.

When you absolutely have to go but don't have anywhere to go, use the Do-All Outdoors Pee Pee Bottle.



[via Brian]

October 12, 2011 at 11:01 AM | Permalink | Comments (2) | TrackBack

Experts' Expert: Errol Morris on how to interview someone

Screen Shot 2011-10-05 at 9.55.08 PM

Long story from Bloomberg Businessweek short: "Shut up and listen."

Other observations by Morris:

I think an interview, properly considered, should be an investigation. You shouldn't know what the interview will yield. Otherwise, why do it at all?

I started developing the shut-up-and-listen school of interviewing in the 1970s. The cassette tapes got longer and longer — first 30 minutes, then 60, then 120 — and the number of words I spoke became fewer and fewer. I was really proud of the interviews where my voice wasn’t on the tape at all.

Be well prepared, though. I’m surprised at how many people don’t prepare.

I never go into an interview with a preconceived set of questions.

Don’t be afraid of technology. Technology limits things, but it makes other things possible.

October 12, 2011 at 10:01 AM | Permalink | Comments (1) | TrackBack

"Handy" Sticky Notes


Get it? Hand-y.

From the website:



You know what separates us from animals?



Fingers make the man [and woman], and now, fingers make the sticky note.

Any crumb-bum piece of paper can keep a message, but only these can do it with jazz hands.


Pad measures 4.5" x 4.5".



90 sheets: $9.95.

October 12, 2011 at 09:01 AM | Permalink | Comments (1) | TrackBack

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