1. Welcome

2. Bridging the ICD9 Communication Gap Physician members RPO

5. Communication Foundation Block of Our Profession

10. Problem / Diagnoses List Defines Disease Complexity

11. Communication to Third Party Payers Disease Complexity (aka Burden of Disease) Translate Into E & M codes Non-capitated third party payers Translate Into ICD9 codes Medicare Advantage

12. Proper Flow of Information Medicare Advantage Good coding

13. Proper Flow of Revenue Medicare Advantage

14. Gap in Communication Poor coding

15. Gap in Flow of Revenue

16. Bridging the Gap in ICD9Communication Poor coding

17. Proper Allocation of Resources

23. Schutzhund Pic/analogy

35. Past Medical Information Yes No Have you ever been told your diabetes has damaged your nerves? 6 Have you ever been told your diabetes has damaged your kidneys? 4 Current Symptoms Do you have a numbness, burning, or tingling in your feet or legs? 6 ………………………… DO NOT WRITE BELOW THIS LINE Yes No Patient has loss of sensation with monofilament test or tuning fork 6 Pt has abn urine microalbumin confirmed - 2 specimens over 3 mo’s 4 Pt has decreased eGFR confirmed – 2 measurements over 3 mo’s 4

41. Past Medical Information Yes No Have you ever been told your diabetes has damaged your nerves? 6 Have you ever been told your diabetes has damaged your kidneys? 4 Current Symptoms Do you have a numbness, burning, or tingling in your feet or legs? 6 ………………………… DO NOT WRITE BELOW THIS LINE Yes No Patient has loss of sensation with monofilament test or tuning fork 6 Pt has abn urine microalbumin confirmed - 2 specimens over 3 mo’s 4 Pt has decreased eGFR confirmed – 2 measurements over 3 mo’s 4

55. Past Medical Information Yes No Have you ever been told your diabetes has damaged your nerves? 6 Have you ever been told your diabetes has damaged your kidneys? X 4 Current Symptoms Do you have a numbness, burning, or tingling in your feet or legs? 6 ………………………… DO NOT WRITE BELOW THIS LINE Yes No Patient has loss of sensation with monofilament test or tuning fork 6 Pt has abn urine microalbumin confirmed - 2 specimens over 3 mo’s 4 Pt has decreased eGFR confirmed – 2 measurements over 3 mo’s X 4

56. ( 4 ) Diabetes – Renal Manifestations Diabetes Renal Code Type 2 – controlled/ukn Type 1 – controlled/ukn Type 2 – Uncontrolled Type 1 – Uncontrolled 250.40 250.41 250.42 250.43 Manifestation Code I GFR > 90 II – 60-89 III – 30-59 IV – 15-29 V- <15 Elevated microalbumin 585.1 585.2 585.3 585.4 585.5 585.9 ( 6 ) Diabetes – Neurologic Manifestations Diabetes Neuro -Code Type 2 – controlled/ukn Type 1 – controlled/ukn Type 2 – Uncontrolled Type 1 – Uncontrolled 250.60 250.61 250.62 250.63 Manifestation Codes Polyneuropathy (most common) = 357.2 Peripheral autonomic neuropathy = 337.1