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A Proclaimers re write of “I would run 500 miles”   Leave a comment

When I wake up, well I know i’m gonna be,
I’m gonna be the man who does not wake up next you
When I go out, yeah I know I’m gonna be
I’m gonna be the man who goes away from you
If I get drunk, well I know I’m gonna be
I’m gonna be the man who pukes on you
And if I leaver up, Yeah I know I’m gonna be
I’m gonna be the man who’s leaving you

But I would run 500 miles
And I would run 500 more
Just to be the man who runs a thousand miles
to get away from you

When I’m working, yes I know I’m gonna be
I’m gonna be the man who’s not working hard for you
And when the money, comes in for the work I do
I’ll pass every penny to anyone but you
When I come home(When I come home), well I know I’m gonna be
I’m gonna be the man who takes the home away from you
And if I grow-old,(When I grow-old) well I know I’m gonna be
I’m gonna be the man who’s not growing old with you

but i would run 500 miles
and i would run 500 more
just to be the man who runs a thousand miles
to get away from you

da da da (da da da)
da da da (da da da)

Da Da Da Dun Diddle Un Diddle Un Diddle Uh Da

da da da (da da da)
da da da (da da da)

Da Da Da Dun Diddle Un Diddle Un Diddle Uh Da

When I’m lonely, well I know I’m gonna be
I’m NOT gonna be the man who’s lonely without you
And when I’m dreaming, well I know I’m gonna dream
I’m gonna Dream about the time when beat you again
When I go out(When I go out), well I know I’m gonna be
I’m gonna be the man who does not go along with you
And when I come home(When I come home), yes I know I’m gonna be
I’m better not the man who comes back home with you
I’m better not the man who’s coming home with you

But I would run 500 miles
And I would run 500 more
Just to be the man who runs a thousand miles
to get awayfrom you

da da da (da da da)
da da da (da da da)

Da Da Da Dun Diddle Un Diddle Un Diddle Uh Da

da da da (da da da)
da da da (da da da)

Da Da Da Dun Diddle Un Diddle Un Diddle Uh Da

da da da (da da da)
da da da (da da da)

Da Da Da Dun Diddle Un Diddle Un Diddle Uh Da

da da da (da da da)
da da da (da da da)

Da Da Da Dun Diddle Un Diddle Un Diddle Uh Da

But I would run 500 miles
And I would run 500 more
Just to be the man who runs a thousand miles
to get away from you


Posted April 30, 2011 by briandcox in Uncategorized

ICD10 Making the Job Easier?   Leave a comment






brian d cox





We’ll start, with a quick history of the current medical coding system.

        Currently the medical coding uses the ICD-9-CM system. The system is about 30 years old with various updates throughout the years. ICD-9-CM is based on the ICD-9; (Buck, 2009)the 9th revision of the official version of the International Classification of Diseases complied by the World Health Organization (WHO).}. (Buck, 2009, p.444) The ‘CM’ abbreviation identifies the version to be the clinical modification of the ICD -9. The cm version started, as a tool at first, to provide access to medical records for medical research, education, and administration. “Today the system is used to

  • Facilitate payment of health service,
  • Evaluate patient’s use of healthcare facilities (utilization pattern)
  • Study health care costs
  • Research the quality of health care
  • Predict health care trends
  • Plan for the future health care needs (Buck, 2009, p.444)”

The current system has overgrown the capabilities of the original design.

“The four groups (WHO):

  • (CMS) Centers for Medicare and Medicaid services,
  • (NCHS) National Center for Health Statistics,
  • (AHIMA) American Health Information Management Association.
  • (AHA) American hospital Association

are responsible for the in-depth coding principles and practices and have written the ICD-9-CM in a three volume set. (Buck, 2009, p.446)”

We’ll discuss the three volumes of ICD-9-CM below. The explanation should help to understand the current system, and bring up the argument, will the ICD 10 system be easier to use. The ICD-9-CM three volumes are:

  • “Volume 1     Diseases: Tabular list
  • Volume 2    Disease: Alphabetic Index
  • Volume 3    Procedures: Tabular List and alphabetic Index. (Buck, 2009, p.446)”

To further explain the changes that the ICD 10 system imposes I’ll explain what the different volumes contain.    


    Volume I

  • “Contains the disease and condition codes and the code descriptions
  • (V Codes) Supplementary Classification of Factors Influencing Health Status and Contact with Health Services
  • (E Codes) External Causes of Injury and Poisoning
  • Used in assigning diagnostic codes in a inpatient and outpatient setting (Buck, 2009, p.446)”


Volume II

  • “Used in inpatient and outpatient coding for assigning diagnosis codes.
  • Used as the Alphabetic index for Volume 1. (Buck, 2009, p.446)”




Volume III

  • “Hospitals primarily use them.
  • Used to code procedures
  • Contains codes
    • Surgical codes
    • Therapeutic codes
    • Diagnostic procedures (Buck, 2009, p.446)”


ICD-10 was endorsed by the Forty-third World Health Assembly in May 1990 and came into use in WHO Member States as from 1994 (WHO, International Classification of Diseases (ICD), para1).
Currently the ICD-9-CM uses three to five digits codes, using (approximately 13,600 (ICD10 facts,para 5)) individual codes, ICD 10 added more digits to the codes, up to seven, concerning some people that number of digits will make the system to complicate to use. In addition to the added digits more (approximately 69,000 (ICD10 facts, para 5)) codes were added to make the coding more specific.

    Using the quote below, as an example of how CMS responded to the question, “Is ICD 10 to complicated”

“The increased number of codes in ICD-10-CM/PCS will make the new coding system impossible to use.FAC

Just as an increase in the number of words in a dictionary. Doesn’t make it more difficult to use, the greater number of codes in ICD-10-CM/PCS doesn’t necessarily make it more complex to use. In fact, the greater number of codes in ICD-10-CM/PCS makes it easier to find the right code. In addition, just as it isn’t necessary to search the entire list of ICD-9-CM codes for the proper code, it is also not necessary to conduct searches of the entire list of ICD-10-CM/PCS codes. The Alphabetic Index and electronic coding tools will continue to facilitate proper code selection. It is anticipated that the improved structure and specificity of ICD-10-CM/PCS will facilitate the development of increasingly sophisticated electronic coding tools that will assist in faster code selection. Because ICD-10-CM/PCS is much more specific, is more clinically accurate, and uses a more logical structure, it is much easier to use than ICD-9-CM. Most physician practices use a relatively small number of diagnosis codes that are generally related to a specific type of specialty. (ICD10 Myths and Facts, 2010, para 4).”


    In addition to the coding aspect, they have super bill concerns as well, as stated in the quote below:



“ICD-10-CM-based super bills will be too long or too complex to be of much use. FACT

Practices may continue to create super bills that contain the most common diagnosis codes used in their practice. ICD-10-CM-based super bills will not necessarily be longer or more complex thanICD-9-CM-based super bills. Neither currently-used super bills nor ICD-10-CM-based super bills provide all possible code options for many conditions. The super bill conversion process includes:

  • Conducting a review that includes removing rarely used codes; and

  • Cross-walking common codes from ICD-9-CM to ICD-10-CM, which can be accomplished by looking up codes in the ICD-10-CM code book or using the General Equivalence Mappings (GEM). (ICD10 Myths and Facts, 2010,para 11)”

    More issues seem to revolve around the code composition. ICD 9-cm codes are mostly numeric, with E and V codes alphanumeric and valid codes of three, four, or five digits. ICD-10,” All codes are alphanumeric, beginning with a letter and with a mix of numbers and letters thereafter. Valid codes may have three, four, five, six or seven digit. (ICD10 facts, para 5)”.

WHO has written a working system, even with all the controversial changes. Below is a quote from the WHO website backing up that statement:



“The success of ICD-10 is unequivocal:

_ 70% of the world’s health expenditures (3,500 Billion USD) ii are allocated using ICD directly for reimbursement and resource allocation;

_ 110 countries that collectively account for 60% of the world’s population use cause of death data coded with ICD for health planning and monitoring in a systematic fashion.

_ ICD-10 is cited in more than 20,000 scientific articles. (WHO International Classification of Diseases (ICD)p.5, para 5)”.

I’ll leave this conversation with that said.




icd 11 revisions. (n.d.). Retrieved 7 26, 2010, from WHO international:

ICD10 facts. (n.d.). Retrieved 7 26, 2010, from aap:

ICD10 Myths and Facts. (2010, 7 25). Retrieved 7 25, 2010, from CMS:

WHO > Programmes and projects > Classifications > International Classification of Diseases (ICD). (n.d.). Retrieved 7 27, 2010, from World Health Organization:







Posted August 19, 2010 by briandcox in Uncategorized

Medicare explanation as a letter to Mr.smith   Leave a comment

Congratulations, Mr. Smith,

Upon reaching your 65th birthday and working at least ten years with a Medicare paying employer and you being a permanent citizen you qualify for the United States Medicare healthcare program. You have to apply for the coverage if you’re not already receiving social security benefits, railroad retirement Benefits or disability social security benefits. Medicare Mr. Smith has four different programs, Part A, Part B, Part C, and Part D.

Part A no cost, the program covers inpatient care in an acute care hospitals and skilled nursing facilities, hospice care and some home health services. Simply, explained the hospital costs.

Part B (monthly premium) and you pay more if your individual income exceeds $80,000, $160,000 with a combined income.

The Part B plan covers physician services, outpatient hospital care, and other services not covered by Medicare. Simply put physician expenses are covered. Mr. Smith, Part B has deductibles and coinsurance payments, their listed below:

  • $135 annual deductable.(2009)(Placeholder1)
  • 20% of Medicare approved amount after the deductable is met.(Placeholder2)
  • 20% of all occupational, physical and speech-language therapy services.(Placeholder3)
  • 20% of the Medicare-approved amount for Durable Medical Equipment(Placeholder4)
  • 50% for most outpatient mental health care.(Placeholder5)
  • First three pints of blood plus 20% of the Medicare-approved amount for additional pints of blood (after the deductable is met).(Placeholder6)

Part C (Monthly premium) Medicare Advantage program, Mr. Smith these programs are Medicare approved health options managed by private companies. Part C includes all Part A and Part B plans coverage. Mr. Smith while with the part C plan you have the option of enrolling in one of these plans:

  • (HMO) A health maintance organization.(Placeholder7)
  • (MSA) A Medicare savings account plan.(Placeholder8)
  • A Medicare special needs plan.(Placeholder9)
  • (PPO) Preferred provider organization.(Placeholder10)
  • (PFFS) A private fee-for-service plan.(Placeholder11)

Mr. Smith, let’s take a few minutes to discuss optional plans they might be beneficial to you. The HMO, and PPO plans are considered coordinated care plans which means the physician make arrangements with other providers or agencies to provide care for you. Mr. Smith in certain regions of the country, private insurance companies offer the PFFS program. The private insurance company receives an amount of money preestablished each month; the provider decides how much it pays for services. The providers are authorized to charge up to 115% of the plan’s payment schedule and the providers are reimbursed with a fee-for-service basis. Chronic illnesses, management of multiple diseases and focus care management can be covered with the Medicare special needs plans that would benefit from the part A and Part B plans. The individuals have limited membership to the plans and the individuals are eligible for both Medicare and Medicaid, have certain chronic or disabling conditions, or reside in certain institutions.

MR. Smith wait on you nap! I have one more part from Medicare to explain, Part D.

Part D Medicare Prescription Drug Coverage covers all the Medicare beneficiaries prescription drugs cost. Yes there is a premium to join, not only that if you wait until your first eligibly you have to pay a penalty. These plans are administered by private insurance companies and other approved private companies. Signing up for Medicare’s HMO plan (Medicare advantage plan) is one, of two ways to obtain prescriptions. Mr. Smith to your benefit the deductibles’ and premiums vary. The other is to join a prescription plan that adds coverage to the original plan. These plans include private-fee-for service plans and Medicare Medical savings Account plans.

That’s it! Mr. Smith all the Medicare four parts are explained above. But wait, the United States has more to offer; these other plans offer the same coverage as Medicare and a few cover prescription drugs. Medicare Cost Plans, Demonstration/pilot program, Programs of All-inclusive Care for the Elderly (PACE).

I’ll explain these programs in more depth below Mr. Smith;

Medicare Cost Plans the medical is handle pretty much the same way as Medicare Advantage Program, the plan is a type of a HMO. Mr. Smith you pay the coinsurance and deductibles of Part A and Part B plans. The Original Medicare Plan covers the services if you receive health care from a non-network provider. Mr. Smith two more options under these choices; A Demonstration/pilot program a few follow the Medicare Advantage Program these programs are designed to test improvements in Medicare payment, coverage, and quality of care. Mr. Smith the last option Programs of All-inclusive
Care for the Elderly (PACE). The program provides services to an individual in the community who lives and receives health care; the services include medical, social, and long term care. Some states the program is an option with both Medicaid and Medicare. I have the four eligibility requirements here; 65 years old, Resident of the area covered by the PACE program, Able to live safely the community, Certified as eligible for nursing home care by the appropriate state agency(Placeholder12)

Ah, Yes Mr. Smith if you are going to have elective surgery your provider has to notify you (Surgical Disclosure Notice) of the out-of-pocket expenses and the non covered procedures if the amount is more than $500. Medicare defines elective surgery as surgery that can be scheduled, is not an emergency and if delayed, would not result in death or permanent impairment of health. Oh there is more Mr. Smith; way back in 1986 an act passed by the Omnibus Budget Reconciliation Act (OBRA) (Placeholder13)passed requirements that must be in writing to the patient; Estimated actual charge for surgery, Estimated Medicare payment, Excess of the provider’s actual charge as compared with the approved charge, Applicable coinsurance amount, Beneficiary’s out-of-pocket expenses.

Mr. Smith there is a chance that the service won’t be covered by Medicare, in this situation an (ABN) advanced beneficiary notice will sent to you. If you sign the ABN, you have to pay the services if Medicare denies the service. The ABN should state why the claim is denied. Hospitals have a different name (HINN) Hospital-Issued- Notices of Noncoverage or Notice of Non coverage (NONC). Whatever you do Mr. Smith don’t sign the ABN if the service denied is never covered by Medicare. Instead you want to sign a (NEMB) Notice of Exclusion of Medicare Benefits. Kind of confusing isn’t it, A ABN is used when the service is sometimes covered but the provider thinks it won’t be for the patient, a NEMB clearly state the service is never covered by Medicare and the patient is responsible for the charges. That’s it Mr. Smith, that’s Medicare. So go choose your plan and sign up.

Works Cited

Green, M. A., & Rowell, J. c. Understanding Health Insurance .

Michell Green, J. C. (2008). Understanding Health Insurance A guide to billing and reimbursement. ny: Delmar Cengage learning.


Posted May 20, 2010 by briandcox in Uncategorized

Understanding health insurance essay   Leave a comment

Decisions and Choices

Which one?

73, 0000 people waiting for organ transplant, two thirds are waiting for a kidney. A prisoner is sitting on death row, without an organ donation form signed. A bill sits in congress ready to sign for legalizing organ cloning. Moldova, China, Egypt, Pakistan, India, Israel / Palestine Mozambique, Kosovo have organs for sale across the ocean. The medical community’s having ethical debates on about organ from harvesting and cloning. Decisions, decisions choice’s to choose

Which one? Will leads us down to the human ethical decision. Let’s review the options, organ cloning, and organ harvesting or letting the waiting person die. Having the person die may be acceptable in the other eight countries. That leaves the controversial ethics choices, organ harvesting, donating, or cloning.

Cloning organs would probable the most effective and cost efficient method for the long term. Not saying there won’t be glitches on the way, non functioning organs, growth of the organ failing, and corruption (cloned organ repossessions?). Of course more money must be spent on the research but we already know that. No problems that could not be worked out in the twenty first century.

Cloning organs time, viability and cost are the current major setbacks. Let’s question the option of harvesting organs. Harvesting would have a shorter time for a transplant to happen. The short term cost wise harvesting would be the least expensive choice of the choices. Buying and selling organs would cause too much legal headaches and corruption to be a viable solution.

All in all cloning organs would be the most cost effective choice in the long term. The organs can be tailored to fit the receiver’s body, we can make them without depriving someone else’s a life. Not to mention the employment rise that would happen. But until the issues are resolved we are stuck waiting for donors.

Posted March 13, 2010 by briandcox in Uncategorized

Funny story   Leave a comment


The horse track

Laughing stock

Announcer “Horses antsy in the gates.”

“Bang” The starter fires his gun.

“You Ate My Carrot rockets out of the gate leads by 3 lengths”,”

“Where’s ‘My Carrot, I Make You Pee Pants, Blinders To Small, Saddle to Tight, Too Many Sugar Cubes, side by side the middle of the track”

“Taking up the rear, See nothing But Tail, and You Fall off”

“Quarter pole mark, “Where’s’ My Carrot “on the tail of “You Ate My Carrot,”” Too Many sugar Cubes” sneaking up the rear ,”” I Make You Pee Pants edging ahead of Where’s’ My Carrot”.

“Trouble in the rear!” You Fall Off stumbles,” bucking the jockey off, trying to pass See Nothing But Tail.”

“Nothing But Tail passes on the outside Blinders To Small and Saddle to Tight like their standing still.”

“Nipping at the hoofs of You Ate My Carrot, See Nothing But Tail half a length behind, rounds the last corner.

“Action in the middle of the pack I Make You Pee Pants on the outside blows by Where’s’ My Carrot.”

“You Ate my Carrot, and See Nothing But Tail nose to nose down the last stretch ”

3 lengths behind, I Make You Pee Pants puts the pressure on.”

“Finish line 3 lengths away, losing ground to See Nothing But Tail”

“Now You Ate My Carrot 1 length behind See Nothing But Tail”

The finish line in 2 more horse lengths: See Nothing But Tail is now a half a horse length in front of You Ate My Carrot with I Make You Pee Pants right on his tail.”

“Oh it looks like we have a new winner, See Nothing But Tail final gallop pushes ahead of You ate My Carrot taking first place by a full length, second place in a whirlwind I Make You Pee Pants followed gallantly by You Ate My Carrot.



Posted December 27, 2009 by briandcox in Uncategorized

Daily Chuckle News   Leave a comment

Daily Chuckle news release:

Tweedle brothers expect a spike in Gullible stock market,

Tweedle brothers stock picks stocks to rise:

Tweedle Dees: I expect a sudden but short spike in flame retardant materials expected due to Claus industry.

Tweedle Dums:

YOU BELIEVE ANYTHING ROPES AND STRINGS, leading with the profits in the rope industry. I expect a bigger spike in the rope industry. The company specializes in mass production of Santa Snares.

DOC SMILEY STORK DELIVERS, Expecting a small decrease in due to the Santa Snares situation with the general public.

FARFETCHED REINDEER FEED, Doing exceptional well this quarter, Claus industry being the major buyer.

NOT MY PANT’S, Expected to have a short but sudden spike, due to a extremely large pant size order from Claus industry.

ClAUS INDUSTRY, Have done quite well for the past quarter, even with the request for stimulus money, Denial believed to be due to Grinch’s Manufacturing  (GM). Concourse the biggest buyers of Santa’s Snare are the GM’s plants employees.

Posted December 24, 2009 by briandcox in Uncategorized

Adult carol   Leave a comment

A Woody on Christmas  : Lyrics

I’m dreaming of an Woody on Christmas
Just like the ones I used to know
Where the tops glisten,
and women listen
To hear moans in the bed

I’m dreaming of an Woody on Christmas
With every Christmas card I write
May your days be merry and bright
And may all your Christmases be Hard

I’m dreaming of an Woody on Christmas
With every Christmas card I write
May your days be merry and bright
And may all your Christmases be hard

Woody on Christmas  – lyric


Posted December 21, 2009 by briandcox in Uncategorized