1/🧵 Billing for #LongCOVID💰

It Matters!

What does it mean that docs can now bill using ICD-10 code U09.9 “Post COVID-19 condition, unspecified”effective October 1, 2021?

Let me explain a tad bit why this is so key.

2/ I fully believe in #LongCOVID, and patients must be validated as the experts of their own narrative. BUT, absence of a billing code sent a terrible message to clinicians & pts.

This legitimizes the #PublicHealth catastrophe & facilitates pts being HEARD & SEEN 👁.
3/ Docs “believe” better when they can charge for testing & get pts covered, too. This also allows databases to track & analyze epidemiology of #LongCOVID. That means research can be carried out to answer questions, improve care & prepare for future pandemics. Read an anecdote👇
4/ There are other medical problems like #MECFS & #Delirium w a long history of being stifled by absence of billing codes. I’m breathing a sigh of relief that this ICD10 code is now live @CDCgov, #Medicare, and for private insurance plans.

One step at a time! #Believe
5/ How does it work? U09.0 - the new ICD-10 code - went live Oct 1, 2021. It’s for #LongCOVID or “Post-COVID Conditions.” We now code the primary condition 1st, eg, M35.81 for Multisystem Inflammatory Syndrome, then put U09.9.

👇 See our long “EPIC” list of post-COVID Conditions
6/ People can be reinfected. What then? If a patient has a condition associated w previous COVID-19 infection & develops new active #COVID19, U09.9 may be assigned in conjunction w U07.1 COVID-19 to identify he/she also has a condition from previous COVID.
Conclusion: we now have evidence from millions of patients that they are suffering way beyond acute #covid (U07.1). Into the downstream years they trod (U09.9). We can bill for it. #LongCOVID is legitimized.
But do we care enough? Do we SEE them? We must.

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More from @WesElyMD

12 Oct
1/🧵ROADMAP: What should you know before someone you ❤️ lands in the ICU? @TheDailyBeast
I whittle down IMPORTANT PEARLS & pro-tips about how to approach acute #COVID19 and non-COVID care to avoid life-changing disabilities later.

2/ #COVID pts return home after cutting-edge medical care but many survivors are now living with massive & likely life-long disabilities that include dementia, PTSD, depression & major weakness from muscle and nerve disease. #PICS #LongCOVID

3/ These two entities, #LongCOVID and #PICS, have many overlapping forms of suffering that must be acknowledged by healthcare professionals and loved one for survivors to feel validated & heard. People throughout society in all our communities will benefit.
Read 21 tweets
6 Oct
1/🧵 People ask me, “What’s the main purpose of treating #COVID ICU pts with the #A2Fbundle? (a daily safety checklist of ⬇️ sedation & ⬆️ mobilization). It’s to prevent #PICS related dementia, PTSD, depression & reduce suffering in #LongCOVID.

HOW? What is the philosophy?
2/ For patients it’s about magnifying their #dignity and self-worth by liberating them sooner from us (our treatments that put them through a depersonalization chamber). For HCWs, it’s about purity of service, avoiding hypocrisy, and better self-sacrifice for our patients.
3/ Waking people up and walking them w family at their side in PPE (even inside a room if #COVID+) allows them to feel alive again. Repersonalized! Human. Seen. Drives away #delirium & #brainfog. Wouldn’t you want this?
Read 8 tweets
4 Oct
1/🧵COVID #Vaccine rates by religion:
For many, what they hear on Sunday drives behavior. The highest rates of #vaxx (75%-85%) are found in Catholics, Jews, Atheists, Agnostics & those not affiliated. The lowest rates are white evangelicals (57%).
2/ Non-medical exemptions are a big problem. See these states with the highest rates…this will continue to drive the pandemic, #Delta, and economic and personal hardship of #LongCOVID. Image
3/ We are intent on freedom of expression, freedom of speech & the desire to follow our own path. Good. But when that freedom impinges on the freedom of those standing next to you, what do we do? In mandatory vaxx programs, I believe exemptions should be few & far between. ImageImage
Read 4 tweets
13 Sep
1/🧵🎥 REFLECTION on Fear & Love – what connects 9/11 & #COVID19?
On #Sept11, 2,996 died. 412 were 1st responders running INTO danger.

WIKI: bit.ly/3AiqZN2

WHY did they do this? Listen to my patient Col. Correa👇

HINT: it was NOT religion, politics, or patriotism.
2/ When someone around us needs help, the only universally unifying response is #LOVE.

Wells of love (see pics 👇) must be what we drawn on to achieve success in serving others, whether on 9/11 or in this #Pandemic.
Pics by Robert Mecea & @marklennihan
3/🎥 I cared for 9/11 hero Colonel Victor Correa as he died in our @VA hospital years later. His story is told in #EveryDeepDrawnBreath. He carried men out of the Pentagon saving lives. Watch more of his testimonial…
Read 9 tweets
10 Sep
1/🧵🎥 Tennessee has highest #COVID19 case rate IN THE WORLD 🌎‼️

1/3rd are KIDS, & we haven’t even peaked!

Dr. Jeff Balser, @VUMChealth President & CEO, explains our dire situation. Despite 375M doses of #Vaccine is US alone, we have ~50% overall #Vaxxed & need YOUR help.
2/ This surge is different. The children are disproportionately affected – 1 in 3 new cases. Overall, and this is hard to believe, but we are at our ALL TIME HIGH in admissions. Image
3/ 🎥 Except for immunocompromised patients, almost all in hospital are #unvaxxed. We are re-deploying OR personnel to the ICU and having to curb care for non-COVID pts. It’s just not fair to them. Not getting vaxxed means more suffering for everyone.
Read 5 tweets
1 Sep

Adding baricitinib to steroids will save 1,000s of hospitalized #COVID pts. Our @LancetRespirMed COV-Barrier study is FREE.

I explain👇why it’s such a great #Pandemic discovery story: a new way to ⬇️ COVID19 deaths.

2/ Early in COVID, computers predicted “Berry” (for Bari-citinib), an FDA-approved medication for rheumatoid arthritis, could be repurposed to stop SARS-CoV-2 from killing us. Now we proved it! Why did the computers think it would work?

3/ Bari has antiviral mechanism but mainly we thought it would work by interfering with the intense inflammation the virus 🦠 causes, which is what leads to so much lung, heart, blood vessel, & brain damage (#delirium).

Read 15 tweets

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