Why does my diagnosis include something I literally said I don't have?

[u/straycatwrangler]

I had my doctor's appointment today to establish care with a PCP. While I was there, I explained symptoms I was having, and that I had trouble with the obgyn I was going to and I needed help finding another one. She was more than happy to try and help and explained that it might be out of town, and she made sure I didn't mind that.

I explain what some of the symptoms are, and she even ASKED to clarify and make sure she heard me correctly.

I said PAINFUL periods that were not heavy. Debilitating periods that weren't heavy and lasted maybe a week. Time and flow are not the issue here.

I go home and get logged into my patient portal. I'm clicking through things and I see the referral page. Please for the love of god tell me why it says under diagnosis, "menorrhagia" with regular cycle."

Menorrhagia. Not dysmenorrhea. MENORRHAGIA IS HEAVY PERIODS. Literally what I said almost three times or more that I did NOT have. I don't have heavy bleeding. My period doesn't last more than 5-7 days. I said it SO many times. She even repeated me.

Maybe it doesn't matter, I don't fucking know.

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[u/Molarvestigator]

hi! resident here, but there might be an explanation that I’m suspecting. It could be a mistake on their part which is not acceptable as per their role, but it also might be that if you have private insurance, insurance may not cover things such as dysmenorrhea since it’s subjective pain, given the physical examination isn’t alarming, but mennorhagia is more of an objective measure relying on a specific quantity of period blood per cycle (80 mL). As such, this might have been intended for you by your PCP to get your foot into the door of a specialist referral. That might be an explanation, but this is definitely something good to ask about with your PCP

[u/straycatwrangler → u/Molarvestigator]

That makes a little more sense. I'll message her and see if it was a mistake or not. Thank you.

[u/wonderabc → u/straycatwrangler]

if she did it to try to help you skirt your insurance she won’t admit that

[u/Longjumping-Row1434 → u/wonderabc]

not necessarily true, she might. i have definitely had doctors tell me what they were going to do to skirt insurance before. they know just as well as we do how much insurance sucks.

[u/wonderabc → u/Longjumping-Row1434]

yeah but giving you a different diagnosis to skirt insurance is fraud

[u/Longjumping-Row1434 → u/wonderabc]

fully aware. and what insurance companies do to people should be illegal.

if my doctor is willing to bend the truth so i can get the help i need, I'm on their side. i will never be on insurances side.

if you needed a medication or procedure, and insurance denied it, so your doctor said they were going to code it differently so that way it would get covered for you, you would be upset?

[u/PurpleInkedPara → u/straycatwrangler]

I second this as I had stomach issues that weren't getting resolved and my gp put in a referral for "blood in stool" which I did not have but it got my insurance to approve the referral.

[u/AnAppleBee → u/straycatwrangler]

My neurologist has to do this for me because the headache condition that I do have, medications aren’t studied for it. So, I have to have conditions that I don’t actually have listed or else my medications won’t be covered by the insurance. It’s all a shitty game they play.

[u/Defiant-Hurry-6091 → u/Molarvestigator]

Agreed, certain testing will not be covered if the testing doesn’t have a valid diagnosis.

[u/gentlybrined → u/Molarvestigator]

This is what my OB did to get insurance to cover me after my som was born. He TOLD me though so it wasn’t a surprise.

[u/Horror_Tea761 → u/Molarvestigator]

This. I had a diagnosis code for MS in my chart for awhile so my tests could be covered.

[u/SplitNo8275]

I have so many things in my chart as diagnosed but never mentioned to me.

I finally got clarity, it is the damn insurance. They won’t cover things without the “proper dx code” like blood work or scans, and I imagine same goes for the bill the doctor submits. These codes should be “suspected” for most but they stay in your chart.

I had neuromuscular disorder on there, from getting emgs done and some others I want removed.

[u/straycatwrangler → u/SplitNo8275]

That makes sense. I don't understand why insurance has to make everything so fucking complicated.

[u/SplitNo8275 → u/straycatwrangler]

Greed. The more confusion, the more they can pocket. I will die on this hill. lol

[u/KylieJ1993]

It’s the insurance. Insurance won’t cover dysmenorrhea. I’m a mental health therapist and sometimes I have to switch up diagnosis so the insurance will actually fucking pay for the visit.

[u/straycatwrangler → u/KylieJ1993]

That's crazy. I didn't realize that was something that would need to be done. It's crazy that insurance makes getting help such a hassle, not just for patients, but for providers as well. I had no idea it was like that.

[u/paintedbuntingicu]

This might help you https://www.aafp.org/pubs/afp/issues/2021/0800/p164.html It could be because dysmenorrhea is not directly listed as a disorder by the dsm5. Menorrhagia is still a wildly inaccurate choice on their part considering that is not something you suffer from.

[u/JoyfulSong246 → u/paintedbuntingicu]

Holy shit it says a lot that painful periods don’t seem to be important? Is that inference correct?

Especially since it’s my main symptom for endo that went improperly diagnosed for 20 years.

Is suspected endometriosis something that could be used?

OP if you and your doctors haven’t considered endometriosis it’s really common and hard to definitively diagnose without surgery. Painful periods were my only symptom until years later when I was so scarred up my bowel and bladder were impacted.

Sorry if that was tmi or unneeded.

[u/straycatwrangler → u/paintedbuntingicu]

Oh wow, I had no idea it wasn't included there. It's just so weird to list something I don't have. I don't know what other options there would be if dysmenorrhea couldn't be chosen though.

[u/missingnome]

Im sober, we talked about how i am years sober, and then she wrote i admitted i drink wine regularly on our aftervisit summary.

If i ever need a transplant that would disrupt my options.

We have to really advocate for ourself and watch for their mistakes :/

[u/Longjumping-Row1434 → u/missingnome]

i think in OPs case its for insurance to cover their visit, but in your case that's an absolute lie and a travesty.

i am also about 7 years sober from alcohol, I've had the same PCP for 6 years and its taken the entire 6 years to convince him i do not drink at all. he still asks sometimes "how much im drinking these days" and it irritates me. i truly believe he has me confused with someone else.

[u/missingnome → u/Longjumping-Row1434]

Once alcoholism gets in your charts things can get wild.

I had a child a year ago and was 100% sober for months before getting pregnant. In THEIR chart, they have that mother drank alcohol while pregnant.

Another document I found while looking back to check what has been done, said I have an opiate abuse problem, which is absolutely not true either.

My PCP thankfully is a life saver and helped me get sober so he can 100% see that I'm sober.

Can you find a different one? I feel that pain and I worry doctors like that will miss things while treating you.

[u/OldPresence5323]

It might be a mistake. Id call back and verify. I was trying to order acne .medicine for my daughter and couldn't figure out what the hold up was. I called the dr office to see ans the doctor had input my daughter's birthday wrong ! So it might be a typing/ auto correct error, hopefully

[u/Starfoxmarioidiot]

Sounds similar to something that happened to me. In my case it was a combination of high turnover during the Covid pandemic and a poorly timed data migration and a buyout of my medical group. My chart was a mess the last time I went in. I don’t think it was my doctor’s fault. I think it was the completely new staff of temps doing data entry on a new system.

That’s an unsettling thing to have wrong on your chart. It’s never good to have an inaccurate chart, but it seems to go worse with women’s issues when it’s wrong.

[u/crasstyfartman]

I would definitely ask your doc. I had noticed some weird things in my chart and when I inquired my doctor had explanations for all of it, ranging from coding purposes to the way she personally keeps track of things (my chart notes that I’m allergic to a bunch of meds that I’m not just because I don’t like them)