If we analyzed the diagnosis codes we send to the insurance companies for payment, the ICD-9 code 724 is one of our top 10 codes. When ICD-10 implementation begins, that code will become a long string of codes with suffixes like 724.2 for plain low back pain or 724.3 for sciatica. Medicine isn’t going to get any simpler with the advent of ICD-10 but the methods of evaluating and treating low back pain won’t change much. With the ever-changing insurance landscape and more and more patients having large deductibles for which they are responsible, ordering diagnostics tests can be difficult and often delay a full evaluation. There is no escaping the reality that many of us (myself included) factor in finances when making medical decisions. One of my children recently had a strange headache. This is a teenager with no history of headaches but who has a strong family history of subarachnoid hemorrhages that are due to aneurysms in the brain. Whether it’s because I am a doctor-mother who knows too much or I am a mindful clinician that doesn’t want to miss a condition that can be cured with surgical intervention, I agreed twith the MRI of the brain of my child…..until I had a deductible of $1241.00. My insurance was paying the other $2300, but it still made me pause. And I had to ask for a payment plan with the radiology office. I don’t know of many people who have $1200 laying around and if the radiology office will set up a payment plan without interest, that beats putting it on a credit card.
This long, round about story is to discuss the new evidence about treating low back pain. There was a segment recently on National Public Radio that you might find interesting and helpful. I’ve also linked a YouTube video that is helpful. I’ll apologize for any YouTube embedded ads, I can’t control those.