You've hit the nail right on the head Bob, most of our patients have the
"blue" type insurance:  Blue Cross, Blue Shield, Medicaid, etc.  (The
ones that require the most specific ICD-9 coding possible and then
perhaps, with a little luck they might THINK about paying the bill...) 
We're also nonprofit, so it's often difficult to get things that we need.
 I have a collection of ICD-9 codes from various sources, and the best
ones I have have been pirated from neighboring hospitals.  I'd love a
full book, but it's just not economically feasible.  I also have to look
out for the patients though ~ the previous tech didn't always code things
as specifically as she could, and I've had to re code stuff for patients
so that they weren't stuck with huge bills that they couldn't afford... 
Then there are the specimens brought to the lab fresh and plopped down on
my clean counter with no formalin, no diagnosis, just a billing sheet....
 I'd be thankful for anything I can get!

Janay Zeck, HTL (ASCP)

On Tue, 20 Nov 2001 14:41:40 -0500 (EST) RSRICHMOND@aol.com writes:
> You need a full ICD-9 coding book (such as the St. Anthony book), 
> which 
> managers are often reluctant to buy for mere pathologists and 
> histotechnologists. Lists made up by amateur coders aren't much 
> help.
> Many insurers, including Medicare, require ICD-9 coding of diagnoses 
> before 
> they'll pay, and there are a lot of tricks to increase the 
> likelihood of 
> payment.