So, I have a new psychiatrist and again, AND with a new mental health practitioner I always have to start at the beginning with leading the horse to water. Just give me my MORMON COCKTAIL (hmm…maybe Mormon Cocktails will be tomorrows subject) Prozac (fluoxetine) 60 mg (1 tid) and Xanax (alprazolam) 1 mg (1 tid) and I’ll be “functional”. However, no…they always assume that I need whatever NEW SSRI/mood stabilizer/antipsychotic medication on the market. Of course, it doesn’t help that I live in
Florida the prescribed drug
abuse capital in the . Right now, I'm being prescribed Latuda (an antipsychotic) generic name lurasidone hci 40 mg 1 po qd. The other objection I have for Latuda is that its kind of expensive and doesn't have a generic equivalent yet, so I have to pay the 40.00 a month brand name copay. Good thing, is..there's no increased appetite side effects, in fact..SUPPOSEDLY (but I haven't noticed in 2 weeks using it) it has an anorexic effect (I'd only be so lucky). Ooo..maybe DOCTOR MAILE will try 40 mg, TWICE DAILY! We'll see. John and I haven't noticed a difference...in either the depression or the anxiety symptoms...however if I do feel the anorexic effects working...ok..I'll trade that off for the Prozac! Or maybe I can get the Prozac, Latuda AND the Xanax! hmmm..What a combination..ooooo..another Mormon Cocktail..we shall see! US
Forgive me as I ramble-babble about my psychiatric diagnosis code that has been applied to be so freely! So, the ICD9 diagnosis code I was given was 296.89. Bipolar II. Odd how THIS is the NEW depression (311)/anxiety (300.01) diagnosis. Granted, in the past just having a diagnosis of 311 and 300.01 was very not really considered “medically necessary” in terms of getting approval from my health insurance company when trying to get more mental nervous (MN) visits approved, I see where having 296.89 would be considered “more medically necessary” as opposed to 311 and 300.01.
That being said..what apparently I’ve been categorized as having is “bipolar “light””..whatever..basically they consider my “mania” stages as being HYPOMANIC as opposed to HYPERMANIC. Hypermanic being the classic MANIC DEPRESSED (which is what the old 296.89 code was classified as..MANIC-DEPRESSION..so not me). I think I shy away from the “MANIC” moniker because I don’t think I’ve ever been manic..rather always had a dark doom and gloom personality. I think “mania” is someone that has feelings of “elation” and “joy” “boundless energy” followed by the "CRASH" of major depressive episodes. Sorry..never hard boundless energy or “joyous energy”. That being said. the axis II symptoms, I admit do fit me..are what is called “HYPOMANIA”, the inability to sleep, anxiety, worry, the spending money issues (when I’m not under watch) and general doom and gloom symptoms that I’ve always had..Ok..so..what I see is that they’re putting what was called depression anxiety disorders and stuffing them into the “medically necessary” part of the ICD9/ICD10 coding so that now I fall into (medically speaking) the MEDICAL NECESSITY category. Which is fine. I just don’t agree with the medication, unless I feel a decrease in appetite.
ANOTHER REASON why I don’t like the “296” part of the diagnosis code is that the ICD9 prefix of 296 is REALLY TOO CLOSE FOR MY COMFORT ZONE to the ICD9 prefix of 295 which is SCHIZOPHRENIA,.......something you do NOT WANT ON YOUR HEALTHCARE RECORDS, unless you really ARE schizophrenic (and if you’re schizophrenic, I understand you really don’t’ CARE you have that diagnosis)! This is actually one of the MOST MISTYPED DIAGNOSIS’ OUT THERE! Think about it..one slip of the key..and you go from being bipolar to SCHIZOPHRENIC due to a typo from some stupid data entry person in some foreign country! Nothing I can do about it right now..well..other than to keep checking the ICD9 codes that are billed to me and get the 295 changed to a 296 was soon as it pops up..but then the damage is already done a lot of the times..It’s REALLY hard to get RID of a diagnosis code than it is to get the RIGHT code applied to you and correctly BILLED!
Ok..now that I’ve thoroughly confused everyone (the 4 people who read this entry that weren't totally freaked out in the first paragraph)..Let me know YOUR ICD9 CODES! I love medical coding..if anything that’s my happy manic state besides nail polish..medical coding! YEAH! Just send me a diagnosis code or diagnosis and I’ll code it or interpret it for you! I don’t even need the book! I just know them..kind of savant like!