The U.S. is in the middle of flu season this month and the opioid crisis appears unabated.

There are several public health issues that are impacting the United States at the moment, and this article will focus on two of them: flu immunization and the opioid epidemic, in particular.  

Have you received your flu shot for this season? It is not too late to be immunized! According to the Centers for Disease Control and Prevention (CDC), influenza activity was elevated for the week ending Jan. 12. Influenza A (H1N1)pdm09, influenza A (H3N2), and influenza B are the culprit viruses to date. Nine states are experiencing high activity (Colorado, Connecticut, Georgia, Kentucky, Louisiana, New Hampshire, New Jersey, New Mexico, and Oklahoma). 

There were 3,568 confirmed influenza-associated hospitalizations from Oct. 1, 2018, through Jan. 12, 2019, with the highest rate for adults 65 or older.

Remember that it takes two weeks to be fully immunized. Peak season is December through February in the United States. If you haven’t already, schedule a Z23 (encounter for immunization) visit soon!

The opioid epidemic is another public health issue that has been in the forefront of national news. There were 70,237 drug overdose deaths in the United States in 2017. Age-adjusted overdose deaths increased significantly from 2016. Opioids are the main drug that drives the overdose deaths. The state with the highest age-adjusted overdose rate is West Virginia. The U.S. Department of Health and Human Services (HHS) has developed a five-point strategy for dealing with this public health issue:

  1. Better data
  2. Better pain treatment
  3. More addiction prevention, treatment, and recovery services
  4. More overdose reversers
  5. Better research

This public health crisis is so severe, it is actually impacting our life expectancy. According to Michael Bloomberg, founder of Bloomberg Properties, life expectancy has declined for three consecutive years for the first time since World War I, and opioids are a big reason.

The Centers for Medicare & Medicaid Services (CMS), American Healthcare Research and Quality (AHRQ), and the National Institutes of Health (NIH) are collaborating and exploring coverage for acupuncture for chronic low back pain. This effort is associated with the opioid epidemic, in particular as it pertains to finding alternative methods to treat chronic pain. CMS is soliciting comments on the topic until Feb. 14, with a proposed decision memo to be published on July 15.  The instructions for submitting comments can be found online at To submit a comment, please use the orange “comment” button found at the top of the page.

Acupuncture can be captured in ICD-10-PCS. In the Index, there is an entry for “acupuncture,” with options for breast and integumentary system. There is further specification for anesthesia or the absence of anesthesia. The table is 8E0, with the approach being external and the method identified as “acupuncture.” The only choice is at character 7 (qualifier), which identifies anesthesia or no qualifier. If your facility is considering offering this service to inpatients, it may be good information to capture for future data analysis. Acupuncture can be reported using CPT 97810-97814 for outpatient and physician office services. The codes will be required to determine coverage if it is adopted.

Please remember that the ICD-10-CM/PCS and CPT codes assist with the data reporting for all public health issues.

Program Note:

Listen to Laurie Johnson report this story today on Talk Ten Tuesday at 10 a.m. Eastern.

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Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer

Laurie Johnson is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an AHIMA-approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and is a permanent panelist on Talk Ten Tuesdays

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