In the complex world of healthcare, terms like 'diagnosis' and 'billing code' often intermingle, leading to patient confusion. Understanding these terms, especially in the context of the Endocannabinoid System (ECS), is crucial for patients and medical professionals.
When in pain, feeling significant discomfort, or knowing something is genuinely wrong, a consumer is the most vulnerable. Getting confused and even afraid of what may happen without guidance becomes easy.
The Difference Between Diagnosis and Billing Code
Diagnosis:
This is the identification of a disease or condition by a medical professional. It is based on a thorough examination, including patient history, symptoms, and often various diagnostic tests. The diagnosis is a critical step in determining the appropriate treatment plan.
Billing Code:
In contrast, a billing code, often referred to under systems like ICD-10 (International Classification of Diseases, 10th Revision), is used for administrative purposes. These codes allow healthcare providers and insurance companies to communicate about procedures and diagnoses in a standardized language. Billing codes are used mainly for insurance claims, health statistics, and record-keeping.
The ECS plays a pivotal role in maintaining bodily homeostasis. It involves endocannabinoids like Anandamide and 2-AG, receptors, and enzymes. However, there needs to be a significant knowledge gap in the medical community regarding the ECS. This lack of awareness can lead to misinterpretations or oversights in diagnosing and treating conditions likely related to the ECS.
The issue at hand is that most 'practicing' physicians and medical professionals know very little about the Endocannabinoid System due to the stigma placed on Cannabis and the recent discovery of it. The scientific discovery of a bodily system only 30 years ago is a very short time for medical research.
There's a massive movement of very astute scientists with credible studies who have a history in the medical field or still are in a related position but are moving into Endocannabinoid medicine that we find extremely helpful in educating those of us fortunate enough to know them.
The Misconception of Billing Codes as Diagnosis
Patients often misconceive a billing code as their actual diagnosis. However, these codes can sometimes be more about symptom descriptions or preliminary impressions than a definitive diagnosis. For instance, a code for chronic pain doesn't specify the underlying cause, which could be linked to an imbalance in the ECS.
Impression vs. True Diagnosis
Impression:
This is an initial understanding or a tentative identification of a patient's condition. It's a starting point that guides further testing and investigation. When you first visit the doctor with a complaint, what they believe is wrong is known as the 'impression' much like the first impression you get when you meet someone - now it's time for tests to confirm that or move on to something else.
Sometimes, a pain in our belly is a gas bubble; sometimes, it's an ulcer, and other times, it could be something much worse, so it's a matter of finding out vs. reading that initial impression and having a scared - I know how hard that is to do.
Actual Diagnosis:
This comes after a comprehensive evaluation and often multiple consultations. It's a well-informed conclusion drawn from many data points such as MRIs, X-rays, Blood tests, and maybe even a PET examination - and even that requires a biopsy or other markers to determine the actual 'diagnosis'.
What many of us find in research is the Endocannabinoid System (ECS); its tone or reflection of receptors, availability, and endocannabinoids in it is an excellent diagnostic tool - far more than just a place for Cannabis to rest its head at night. So it's no wonder that cannabinoids from the plant can be synergetic with cannabinoids from our body - or cause issues such as imbalance or dysfunctions.
Bridging the Gap
To bridge the knowledge gap, especially regarding the ECS, healthcare providers must engage in continuous education, and many who are practicing medicine now need that initial education they never got in college. This includes understanding how cannabinoids like THC, CBD, CBGa, and others can influence the ECS and contribute to overall health and wellness.
Also, practicing physicians should be aware of the Endocannabinoid System and ECS Tone and learn about dysfunctions far beyond what's often billed as 'CUD' - or Cannabis Use Disorder. With so few options, it's no wonder doctors grab at that and change stats, skewing the actual numbers due to a lack of education on the issue. A use disorder has many definitions, but merely using something one is unaware of wouldn't qualify a patient.
For Patients who don't understand the difference between Impression and Diagnosis:
Always ask for a clear explanation of your diagnosis and how it was determined. Sign into your online chart and read the lab reports, the imaging, and more. Study yourself like you would the menu of your favorite dispensary or restaurant.
"Understand that a billing code on your insurance paperwork might not fully represent your health condition." -Mike Robinson, Global Cannabis Educator
For Medical Professionals:
Strive for precise diagnoses and be aware of the nuances of billing codes. Incorporate ECS education into your practice to enhance patient care. Take the time to explain to patients that you believe it might be 'this' but you're doing tests as you're unsure of the etiology of their complaint. That leaves a patient knowing the doctor is unsure vs. thinking an impression is a diagnosis - if doctors don't want patients googling then it's a good idea to give them a tad more information and soft guidance such as this.
Conclusion
Understanding the difference between a diagnosis and a billing code is essential. As we continue to uncover the complexities of the ECS, both medical professionals and patients must be equipped with accurate information to make informed decisions about health and treatment.
-Mike Robinson, Global Cannabis Educator and Creator of ECS Balance Control, The Researcher OG
© Mike Robinson, Global Cannabinoid Research Center
