
November 23, 2002
Diagnosis and Symptoms
Question from Corpus Christi, Texas, USA:
What does it mean when the diagnosis goes from abnormal weight gain to acanthosis?
Answer:
Part of the stupid United States health coding and insurance payment system means that obesity cannot be used as a correct diagnostic code. So, if one codes for obesity, health professional, clinics and hospitals never get paid. Therefore, other diagnoses that are allowable are used. This could be abnormal weight gain, for instance. Also, if someone is overweight and they have acanthosis nigricans, this is a signal of syndrome X and future high chances of diabetes, lipid problems, early heart attacks, Polycystic Ovary Syndrome, abnormal periods, severe acne etc. However, acanthosis is also a legitimate diagnosis that gets paid while obesity does not.
For the patient, this does not mean anything except that the professionals providing guidance and consultation get paid for their expertise and advice. You should discuss this with your health care providers since they can tell you what all this means and what needs to be done: usually weight loss, less caloric intake and more daily activity. Sometimes also medications that work to lower insulin resistance such as [metformin] are indicated, and, if hypertension and hyperlipidemia are also present, then medications to lower blood pressure and high lipid levels may also be prescribed.
SB