Coding A Morning
PLACE OF OCCURRENCE, HOME ICD-E849.0
6:00 AM
Alarm goes off. Hit snooze button. CIRCADIAN RHYTHM SLEEP D/O IRREG SLEEPWAKE TYPE ICD-327.33
6:30
6:45
7:00
7:40
7:55
OTHER SPECIFIED PLACE OF OCCURRENCE ICD-E849.8
8:15
6:00 AM
Alarm goes off. Hit snooze button. CIRCADIAN RHYTHM SLEEP D/O IRREG SLEEPWAKE TYPE ICD-327.33
6:30
- Alarm goes off for third time. Ready to hit snooze button, but knee in ribs from wife prevents more snooze button procrastination. CONTUSION OF CHEST WALL ICD-922.1, ADULT MALTREATMENT UNSPECIFIED NEC ICD-995.8
- Feeling tired, go to make a pot of coffee. CAFFEINE ADDICTION ICD-304.40
- Fill bowl with Lucky Charms and start eating. UNSPECIFIED NUTRITIONAL DEFICIENCY ICD-269.9, HYPERGLYCEMIA ICD-790.29
6:45
- Realize that coffee pot needs to be turned on for it to make coffee. ATTENTION DEFICIT DISORDER, ADULT ICD-314.00, LISTLESSNESS ICD-780.79
- Turn coffee pot on and wander to check email, blog, Twitter, Facebook, etc. OBSESSION ICD-300.3
- Daughter wanders in with dazed expression and blanket draping shoulders. STUPOR ICD-780.09
- Speaks only in soft, irritated grunts. SELECTIVE MUTISM ICD-313.23, E/M 99212 ENCOUNTER, ESTABLISHED, BRIEF
7:00
- Bring cup of coffee to wife in bed. She moans when she looks at the clock. Another morning headache. E/M 99215, ENCOUNTER, ESTABLISHED, HIGH COMPLEXITY; OTHER COMPLICATED HEADACHE SYNDROME ICD-339.44, OTHER SPEC MENOPAUSAL&POSTMENOPAUSAL DISORDER ICD-627.8
- Wake up other children who return evil glares for gentle nudging. CHILD EMOTIONAL/PSYCHOLOGICAL ABUSE ICD-995.51; E/M 99214, ENCOUNTER, ESTABLISHED, MODERATE COMPLEXITY
- Walk to shower and get frustrated at towels not hung up. ANGER ICD-312.00
- Shower, shave, and get dressed. LACERATION, FACE ICD-873.40
- Walk downstairs to find kids sulking and wife frustrated. UNDERSOCIALIZED CONDUCT D/O UNAGRESSIVE UNSPEC ICD-312.10
- Try to give her advice. COUNSELING FOR PARENT-CHILD PROBLEM UNSPECIFIED ICD-V61.20
- Wife glowers. MARITAL&PARTNER PROBLEMS UNSPECIFIED ICD-V61.10
- Say: “We have to leave in five minutes!” in an angry voice. PROBLEMS WITH COMMUNICATION ICD-V40.1
- Children glower. FAMILY DISRUPTION D/T PARENT-CHILD ESTRANGEMENT ICD-V61.04
- Wife sighs and chides for the tone of voice. COUNSELING FOR PARENT-BIOLOGICAL CHILD PROBLEM V61.23; E/M 99215, ENCOUNTER, ESTABLISHED, HIGH COMPLEXITY
7:40
- Finally in car with daughter, driving to school. CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN CPT-99467
- Daughter still not talking more than mumbles. OBSERVATION CHILDHOOD/ADOLES ANTISOCIAL BEHAVIOR ICD-V71.02
- Turn on iPod and play music daughter doesn’t like. PASSIVE-AGGRESSIVE PERSONALITY DISORDER ICD-301.84
7:55
- Daughter dropped off, running frantically to not be tardy. Angry that “we are always late.” UNSPEC EMOTIONAL DISTURBANCE CHLD/ADOLESCENCE ICD-319.3
- Don’t attempt to explain that it is seldom the chauffeur’s fault. HEARTBURN ICD-787.1
- Nod and smile. FEAR OF WOMEN ICD-300.29
- Drive to work. AGGRESSION ICD-312.00
OTHER SPECIFIED PLACE OF OCCURRENCE ICD-E849.8
8:15
- Arrive at work, greeted by a long list of unsigned charts that materialized mysteriously overnight. DEPRESSION, SITUATIONAL, ICD-300.4
- Go to kitchen and pour another cup of coffee – mega jumbo size. CAFFEINE EXCESS ICD-305.90
- First patient status is “arrived” even though appointment is for 8:45. Sigh loudly. AVOIDANT PERSONALITY DISORDER ICD-301.82
- Check email, blog hits. DEPENDENCE ON OTHER ENABLING MACHINE ICD-V46.8
- See patients, answer phone messages, assess lab and x-ray results, and periodically check email, blog, etc. ADVERSE EFFECTS OF WORK ENVIRONMENT ICD-V62.1,
- Talk with drug reps who explain advantages of drugs which have been out for many years. AMNESIA, PSYCHOGENIC ICD-300.12; E/M 99213 ENCOUNTER, ESTABLISHED, LOW COMPLEXITY
- Get another mega jumbo cup of coffee. PREMATURE ATRIAL CONTRACTIONS ICD-427.61; POISONING BY CAFFEINE ICD-969.71; EROSIVE GASTRITIS ICD-535.40
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