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.
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.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
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
