Physician coding for mental illness reimbursement and the need for mental health parity

Many patients with anxiety and depression initially seek treatment from their primary care physicians. Changes in insurance coverage and current mental parity laws, make reimbursement for services a problem. This has led to a coding dilemma for physicians seeking payment for their services. This study seeks to determine first the frequency at which primary care physicians use alternative coding, and secondly, if physicians would change their coding practices, provided reimbursement was assured through changes in mental parity laws. A mail survey was sent to 260 randomly selected primary care physicians, who are family practice, internal medicine, and general practice physicians, and members of the Harris County Medical Society. The survey evaluated the physicians' demographics, the number of patients with psychiatric disorders seen by primary care physicians, the frequency with which physicians used alternative coding, and if mental parity laws changed, the rate at which physicians would use a psychiatric illness diagnosis as the primary diagnostic code. The overall response rate was 23%. Only 47 of the 59 physicians, who responded, qualified for the study and of those 45% used a psychiatric disorder to diagnose patients with a primary psychiatric disorder, 47% used a somatic/symptom disorder, and 8% used a medical diagnosis. From the physicians who would not use a psychiatric diagnosis as a primary ICD-9 code, 88% were afraid of not being reimbursed and 12% were worried about stigma or jeopardizing insurability. If payment were assured using a psychiatric diagnostic code, 81% physicians would use a psychiatric diagnosis as the primary diagnostic code. However, 19% would use an alternative diagnostic code in fear of stigmatizing and/or jeopardizing patients' insurability. Although the sample size of the study design was adequate, our survey did not have an ideal response rate, and no significant correlation was observed. However, it is evident that reimbursement for mental illness continues to be a problem for primary care physicians. The reformation of mental parity laws is necessary to ensure that patients receive mental health services and that primary care physicians are reimbursed. Despite the possibility of improved mental parity legislation, some physicians are still hesitant to assign patients with a mental illness diagnosis, due to the associated stigma, which still plays a role in today's society. ^

MEDICINE MAN IN TEXAS

The author George (Georgia?) Plunkett Red was the wife of Samuel Clark Red (1861-1940). Dr. Red was the son of Texas pioneer physician Dr. George Clark Red. Dr. Samuel Clark Red was “the county physician of Harris County, one of the organizers of the Harris County Medical Society, a fellow of the American College of Surgeons, and president of the Texas Medical Association.” Not much is known about the author, but given her husband’s position and family history, it can be surmised that she was interested in history and had access to some of the children of other pioneer medical families. There is a brief bibliography for each of the chapters. Part Two of the book consists of biographies of physicians from Texas Counties. Merle Weir, "RED, SAMUEL CLARK," Handbook of Texas Online (http://www.tshaonline.org/handbook/online/articles/fre09), accessed December 10, 2012. Published by the Texas State Historical Association.

The History of Pathology in Texas

The History of Pathology in Texas is the study of the changes of disease in Texas from the frontier days to the 1990s. Marilyn Miller Baker wrote the book for the Texas Society of Pathologists. The book was published in 1996 with a forward by Vernie A. Stembridge, MD, the Ashbel Smith Professor and Chairman Emeritus of Pathology at the University of Texas Southwestern Medical Center at Dallas. The book covers the story of pathology from the "performance of crude autopsies" on the frontier through the emergence of bacteriology and immunology and beyond.

Alcohol; as a food and medicine. A paper from the Transactions of the International medical congress, at Philadelphia, September, 1876.

Mode of access: Internet.

Unitarian word and work : the monthly bulletin of the American Unitarian Association, National Alliance of Unitarian Women, Young People's Religious Union.

Title from caption.

Report.

Report year irregular.

An account of the Battle of Wilson's Creek /

Original t.p. included.

Connecticut's Naval office at New London during the war of the American revolution, including the mercantile letter book of Nathaniel Shaw, jr.,

Includes documents, letters and manuscripts, part of the "Shaw collection", now in the possession of the New London county historical society.

An essay on alcoholic & narcotic substances, as articles of common use : addressed particularly to students /

Second edition issued in 1830 under title: An essay on temperance, addressed particularly to students ...

Essay on the prize-question, whether the use of distilled liquors, or traffic in them, is compatible, at the present time, with making a profession of Christianity? /

A reply to "questions as originally proposed through the agency of the secretary of the American Temperance Society."--P. [3].

Plain facts addressed to the inhabitants of Boston on the city expenses for support of pauperism, vice, and crime.

1st ser., no.5.

The Medicus, a journal for the busy practitioner ...

Ceased publication Dec. 1902.

The National advocate ...

No general t.-p. and index.

Diary of Joshua Hempstead of New London,

Mode of access: Internet.

Annual /

Contains nos. 1-10 for 1906-1917.