Taking the Fear out of Phobia Coding
Christine Geiger, MA, RHIA, CCS, CRC
October 27, 2025
Since Halloween is this week, it is a good time to talk about what scares us. I’m not talking about a masked character with a
Burnout and suicides among climate activists.
In the American Medical Association’s Principles of Medical Ethics, Section 7 of 9 reads:
“A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.”
Of course, there are many possibilities for fulfilling this principle. One of the most well-known healthcare issues in the United States is the disparity in healthcare access and treatment, with minority groups suffering from discrimination in healthcare, whether interpersonal or structurally, based in institutional racism. Once again, in the coronavirus pandemic, the same disparity has become present, with dramatically increased rates of infection and death in black and Hispanic Americans.
As we’ve seen in the climate-related conditions we’ve recently covered in ICD10monitor and Talk Ten Tuesdays, what we see in the coronavirus crisis mirrors these to a close degree. And it will be no surprise when poor, minority communities are hit hardest by the climate instability brought by stronger hurricanes, drought, and wildfires.
Now, amid the coronavirus social and distancing guidelines, the health of the economy is being weighed against the health of the people. That is similar to the concerns of the financial health of the fossil fuel industries being weighed against harmful health repercussions for people. It would seem that this should not be an either/or decision, but that both sides should be a priority, balanced like a teeter-totter over time.
Climate activists have been a necessity because of widespread denial and powerful opposition to addressing climate instability, as well as the knowledge that poor minority groups are most at risk. And we’ve had them, but at some cost.
In psychiatry, I was a founder of the Climate Psychiatry Alliance (CPA). We advocate, deliberate, and educate, but at least until the pandemic, progress was slow.
Other professions connected to healthcare have similar principles. Environmental scientists are quitting academia for climate activism. Quitting a blocking system is one way to avoid burnout. One wrote:
“I was really demoralized.”
Another said:
“But it’s only leaving and finding a completely different way to do things that helped me overcome the stress and burnout.”
However, burnout has become a serious issue for citizen climate activists too. Says one:
“Then you know, you go to a meeting, or you go to a protest, and there are 30 people there, and you’re like, ‘why aren’t we more angry about this?’ And that is where my burnout comes from.”
And there can be worse. Suicide can occur. David Buckel, a lawyer, set himself on fire, ending his life in a climate protest in Brooklyn in April 2018. One estimate is that climate change may cause 26,000 more suicides in the United States by 2050.
I apologize for these painful examples. Climate activism is almost like you’re damned if you do, and damned if you don’t. That ethical way is not always the easy way. The unexpected good news is that not only has the pandemic given activists a rest, but carbon emissions are way down due to less fossil fuel use. So it has never been clearer that human behavior can lessen climate risk. The challenge is whether we will be able to find ways to sustain this as the pandemic hopefully remits over time. It is up to all of us, especially in healthcare, because the harm to health and mental health will be substantial.
Programming Note: Listen to Dr. Moffic report this story live today during Talk Ten Tuesday, 10-10:30 a.m. EST.
Since Halloween is this week, it is a good time to talk about what scares us. I’m not talking about a masked character with a
September is the annual Suicide Prevention Month which is also a reminder to examine our coding considerations. In March of this year, the Centers for
Please log in to your account to comment on this article.
Sepsis sequencing continues to challenge even experienced coding and CDI professionals, with evolving guidelines, documentation gaps, and payer scrutiny driving denials and data inconsistencies. In this webcast, Payal Sinha, MBA, RHIA, CCDS, CDIP, CCS, CCS-P, CCDS-O, CRC, CRCR, provides clear guideline-based strategies to accurately code sepsis, severe sepsis, and septic shock, assign POA indicators, clarify the relationship between infection and organ dysfunction, and align documentation across teams. Attendees will gain practical tools to strengthen audit defensibility, improve first-pass accuracy, support appeal success, reduce denials, and ensure accurate quality reporting, empowering organizations to achieve consistent, compliant sepsis coding outcomes.
Expert presenters Kathy Pride, RHIT, CPC, CCS-P, CPMA, and Brandi Russell, RHIA, CCS, COC, CPMA, break down complex fracture care coding rules, walk through correct modifier application (-25, -57, 54, 55), and clarify sequencing for initial and subsequent encounters. Attendees will gain the practical knowledge needed to submit clean claims, ensure compliance, and stay one step ahead of payer audits in 2026.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.
Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more
Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
