Today we are here with Amir, he came intoour office Valentine Chiropractic originally by iving by and seeing our our previousadsthe newspaper regarding Laser and Decompression treatments. He camewith Plantar Fascitisand came to realize after being examined that he really had Peripheral Neuropathy. He wentto Kaiser, tried to put hima cast for 4 weeks and he started to lose strength inhis legs, he was also on pain pills which were making him violently sick. He was lookingfor some other modality to help him, he felt there had to be something out there that couldhelp. I happened to be iving by your building and i looked and saw that you talked aboutbeing Gluten Free and Peripheral Neuropathy,
so I called and talked to your brother Leonard Valentine and had a good conversation and felt very comfortable that you guys couldhelp me with my chronic plantar fascitis. The pain I had was not justmy heels it wasthe whole bottom of my foot hurt plus my heel and Kaiser was telling me it could come fromyour back so they did back xrays, nothing showed up on my back xrays, so then theysaid it was my weight. It turns out it wasn't my weight it turns out I had another ailment,that needed to be treated and healed, so now since starting treatment which has been about2 weeks and the whole bottom of my foot and my heel that I'm not feeling any pain in.So this is the first time2 years that
you have gone 2 weeks without any pain atall? Correctthat's is phenomenal and being off pain pills for a month, that has beenthe first time2 years. What would you say to those people all around the world whosuffer with plantar fascitis or peripheral neuropathy? We work with people all arounddifferent states who suffer with this very same problem, we can help those people aslong as they are willing to reach out. What would you say to the people else where sufferingwith Peripheral NeuropathyI would say this program works, I haven't even beenthisprogram 7 weeks, maybe 57 weeks this has got to be the program that is going to helppeople, I have found nothing else to help
meyour program is wonderful for treatingand fixing people with Plantar Fascitis or Peripheral Neuropathy.
Welcome to CMS eHealth. By October 1, 2015, the new ICDcoding system will beplace for both diagnosesand inpatient procedures. Using ICD10, s willcapture much more information, meaning they can betterunderstand important details about a patient's healththan with ICD9. The new codes reflecthow health care has changed over the past 30 years with manyadvancesal practice.
You'll notice updates,including definition changes, terminology changes,and a lot more specifics. The most obvious change is thatthe code structure has expanded. While the old codes havethree to five characters, the new codes have up to seven, allowing for more detaileddescriptions. The first three charactersrepresent the egory of disease or health condition,followed by a decimal point.
The fourth, fifth,and sixth characters represent al details,such as the cause of the disease, its severity,and its anatomical loion. Let's look at how this all worksusing the example of diabetes. ICD9 has two major egoriesof diabetes codes, diabetes and secondary diabetes, but ICD10 separates Type 1diabetes from Type 2 diabetes. ICD10 also eliminates the broadegory of secondary diabetes,
instead offeringsecondary options, such as underlyingconditions or causes. To capture more details,subegories can be added to represent both compliionsand affected body systems. For example, the diabetessubegories include ketoacidosis,kidney compliions, ophthalmic compliions,neurological compliions, and circulatory compliions.
Let's say a patient has diabetesdue to an underlying condition. That's code E08,followed by a decimal point. Next come the detailsin the form of subegories, starting with the fourth digit. Ketoacidosis, for example,has a fourth digit of 1. To add even more detail,a fifth digit of zero is ketoacidosis without coma, and a fifth digit of oneis ketoacidosis with coma.
These subegoriesstay the same, no matter what type of diabetesis being described. For example, diagnosis code .621 describes the compliionof foot ulcer. So E10.621 is type 1 diabeteswith foot ulcer, and E11.621 is type 2 diabeteswith foot ulcer. In this example,the provider has documented the egory of diabetesand the compliions.
Small fiber neuropathy is really an interestingcondition because it consists typically of just burning, numbness, pain of the feet,sometimes the hands later on without necessarily having any abnormalities on your EMG or nerveconduction study. So what I tell patients and actually residents or students who trainunder us is that a normal nerve conduction study does not exclude a neuropathy. And wewill confirm this by doing additional testing, specifically the nervous the the examinationat the bedside asking patients about their symptoms, for example, loss of sensation tocool or or hot temperatures, loss of pain sensation and also doing skin biopsies wherewe look at nerve densitiesthe skin both
from the calf and the thigh as well as doinga special test that looks at sweat function bothyour footin the legs as well asthe feet to gauge the level of small fiber nerve damage. Small fiber neuropathy typicallywill progress unless the underlying cause is identified and reversed. Diabetes of coursebeing the most common cause is always screened for. But once the more common causes are excludedand the focus becomes on excluding any underlying secondary disease process but also controllingpain because if patients' symptoms of pain are generally controlled they tend to do prettywell and really have no other major functional deficits. I've really become interested overthe years is how interconnected neurology
and rheumatology are and one thing I oftendo on patients who have unexplained small fiber even autonomic neuropathy is have themsee rheumatology or get evaluated for connective tissue disorders like lupus or Sjogren's orsarcoid and sometimes even if we are not directly involvedtreating the patients, this canbe the first sign of an underlying connective tissue disorder that can then be brought tothe attention of rheumatology and adessed from their standpoint.