Froggy the Great

Randomness XI: Rampant Randomness Randomly Rampaging

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3 day weekend due to Liberation Day!

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5 hours ago, Thes Hunter said:

No matter what our coders say right here, right now, Coders are very important. Our current crowd might be a little strict on the rules, but I'd rather have that than people who are unethical. It's hard for me to tell in some ways where they sit in terms of other coders. I had some, but not nearly as in depth interaction at my other location. But regardless they still do a lot.



 

What I was talking about specifically, is if all the documentation says is Metastatic Cancer X, without saying mets to where, they can only code for Metastatic Cancer X (with possibly the modifiers of Unspecified Location, don't know, didn't look it up. :lol:). They are telling me they can't then go look at the radiology report and see the Radiologist said Mets to the Liver, Lungs, And para-aortic nodes. Which is (usually) all that I do anyway...... (and here's the big one).... BUT.... occasionally what the radiologist reads is an obvious (to us) over read, or they hedge (statistically probable to be a cyst but clinical correlation warranted). Which is why I think coders aren't allowed to 'up code' the Metastatic cancer by specifying the locations of the mets by going and reading the radiology report... even if I wish they could. (But at the same time, there have been a number of times that I went to write a diagnosis more specifically for coding, look at the scan, and find out it doesn't say what I've been told it says (Sometimes it can be a pain in the broccoli to wait for imaging reports to load in the separate system.) and it changes my whole mind about something. So forcing me to look at the scan when I'm doing all of my freakin' computer work isn't always a bad thing.)

 

So there you go. Coders are important. 

 

Oh, yeah, my textbook has pretty well hammered into me that outside of a few particular cases in which nurses' documentation can be used for coding, to go by what the provider documented. If the coder notices a discrepancy between lab reports and provider documentation, a query may be appropriate. I'm still in the "going through the ICD code book section by section" part of my program, so I don't really understand how the query system works, but that will come. ^_^ The next module is CPT/HCPCS coding, then I get to code actual case studies, whee!

 

3 hours ago, Pezler the Polychromatic said:

In that case, you DEFINITELY need to come live in Saskatchewan. We're not called "The Land of Living Skies" for nothing.:B):

 

Hm, tempting! Where I grew up in northern California, thunderstorms were extremely common in fall and winter. On the wet side of Washington (west), they are...much less so, which made me sad. However, MrBoot and I are currently living on the dry side of WA, so I guess it does have its benefits (I do miss all the pine tree forests, though).

 

1 hour ago, Unruly said:

Also, I just kind of realized that I've been using the randomness thread as a bit of a blog, or for what most people would throw on the FriendFace. But I don't put them on the FriendFace because I know my friends and I don't want it being brought up every time we're together. So, you know, sorry for throwing my life at you guys, but you're an easier target that I don't have to later talk to face to face about these same things. I can just imagine you're all a bunch of faceless internet chat bots or whatever, because that makes it easier for me.

 

Heh, I kinda do that too, for similar reasons. In fact, I don't post much on Facebook anymore in general; all of my social circles seem to have collided on it, and it's gotten disorienting.

 

1 hour ago, redambrosia said:

Hubby and I got home just as the storm started, and it was a good thing too, because the street our apartments are on got ravaged. 15 minutes of rain and hail so thick we couldn't see 10 feet away, and the power went out. We went out about 3 hours later in search of food and found that on a quarter mile of that street there were numerous trees down and three spots where the trees took out power lines. 

 

Yikes! I'm glad you missed the worst of the storm, they can be crazy scary to drive in. MrBoot and I drove into a nasty hailstorm while we were on the freeway once, and had to take cover underneath an overpass (along with several other cars) since we were afeared for our windshield. It was quite the adventure. :wacko:

 

Huzzah!

--OneBoot :D

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11 hours ago, Thes Hunter said:

 

Part of our current improvement focus in on improvement of coding. So I've been lots of meetings and lots of discussions on when to use this code or that code. And if using this code will get us a higher mortality calculation. For example putting Constipation as the principal cause of death (it wasn't us, it was someone else. Honest) doesn't get you a very high predicted mortality. But putting Metastatic Prostate Cancer with diffuse bony metastases leading to intractable cancer pain treated with opioids complicated by iatrogenic medicine induced constipation resulting in a rectal fissure which lead to severe sepsis from gram negative bacteremia (Totally made all that up, not a real case, Honest Hipaa people, but it could be). Then everyone can see how he was Dead Man Walking. Even though constipation was a major cause of his death, it was part of a bigger picture. 

 

I myself probably would have coded the Severe Sepsis first, but that is where the debate and discussion as happening. What do you call the Principal Diagnosis, vs. The Reason for Admission, vs. Cause of Death on the Discharge summary, vs. What you put on the death certificate. What Medicare (or insurance) want, isn't necessarily what Life Insurance wants, or what the CDC wants, or what Health Care Quality Metrics want, or what will help bring closure to the family. So there are no easy answers. But it is part of why I've needed to become even more familiar with coding. 

 

So I like the idea of other smart people learning this stuff, so I don't have to learn as much of it. :lol:

I read the above to Awesome Wife and watched her grimace as the diagnosis rolled on.  On the plus side I only mispronounced one word so, go me?

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My arms are sore ::(:

 

Had to have a blood test today, but apparently I have no veins so it required a lot of poking and wriggling and even then they didn't quite get enough.

At least they didn't get really desperate and try to get it out the back of my hand like last time, that was unpleasant.

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10 hours ago, Slush said:

Mine updated saying I'll get it saturday.. i get to do a l forced 7 day challenge.  Paint a diorama before mothers day in under 7 days... or would it be a vignette? How are those defined? 

Either way, good luck to you!

 

8 hours ago, NomadZeke said:

Was working on a TIE fighter model for today that I got half off. Knife slips. "BLOOD FOR THE BLOOD GOD!"  then a few seconds later "Ok not that much"

Better be careful, he gets really testy if he thinks he's been cheated.

 

4 hours ago, pcktlnt said:

Isn't broccoli slang for weed? XD

If so, it's anew phrase that I haven't heard.

(Not that I'm super hip on drug lingo anyway...)

 

2 hours ago, Xherman1964 said:

3 day weekend due to Liberation Day!

Have fun!

 

 

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3 hours ago, Xherman1964 said:

3 day weekend due to Liberation Day!

I am definitely not awake yet. I read that as 'Liberace Day' and was going to say I didn't realize he was so well liked in the Netherlands. 

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3 hours ago, Unruly said:

<snip>

Also, I just kind of realized that I've been using the randomness thread as a bit of a blog, or for what most people would throw on the FriendFace. But I don't put them on the FriendFace because I know my friends and I don't want it being brought up every time we're together. So, you know, sorry for throwing my life at you guys, but you're an easier target that I don't have to later talk to face to face about these same things. I can just imagine you're all a bunch of faceless internet chat bots or whatever, because that makes it easier for me.

No worries. You aren't the only one.

 

13 minutes ago, aku-chan said:

My arms are sore ::(:

 

Had to have a blood test today, but apparently I have no veins so it required a lot of poking and wriggling and even then they didn't quite get enough.

At least they didn't get really desperate and try to get it out the back of my hand like last time, that was unpleasant.

So, I give blood fairly regularly (usually every 8 weeks or so). In my years of giving, it's generally been positive, but there have been a couple of bad/questionable times. The worst involved wiggling, lots of pain, and massive bruising. I was younger then, and didn't know enough to tell the person to get the elf away from me. They got their blood, but I never let that person do it again at least. More recently I got a stick that was *beautiful* I mean the needle slid in smooth as silk! Barely a note of pressure. And then the nurse said "hua..." and I looked over, and the tube was clean. Not a drop of blood. We looked at each other, and then back to my arm, and then at each other again. Then she did something that I could have kissed her for... she asked me what I wanted to do. "Other arm" I offered, and she did it. I'm so so so glad when they don't go fishing...

 

The rain/thunderstorms arrived in Baltimore... not a fun ride into work. And the girls did NOT want to go for a walk this morning...

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I've had a lot of bad sticks. If they're "wiggling it around," make them stop as that can cause nerve damage, among other things. Since learning that, I have made them switch phlebotomists. One made both of my arms so bad a new one had to draw from the back of my hand. I ended up with both arms and my hand bruised.

 

Then there was the stick I barely registered that had zero bruising.

 

I always now try to drink at least eight to ten ounces of water before going to get my blood drawn. It helps them find my vein.

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Morning all!

 

Going to go see Guardians of the galaxy tonight at some theater with a "BD" which from what my buddy tells me whens large seats and screens but is some how different than an Imax? I have no idea... 13 a ticket... Oh well can't wait. Really hoping they have those free posters for the movie too!

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So, here I am at work, being told I need to wait to do something I don't want to do in the first place ( elf around with a perfectly good piece of equipment that is currently operating properly--- on a FRIDAY ).:grr:

 

That is a Monday type job.<_<

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Just now, Chaoswolf said:

So, here I am at work, being told I need to wait to do something I don't want to do in the first place ( elf around with a perfectly good piece of equipment that is currently operating properly--- on a FRIDAY ).:grr:

 

That is a Monday type job.<_<

 

Oh my.. That does sound like a formula for something awful... for a Friday. I do hope for a more positive out come than imagined. ::):

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finish line finish line finish line!!

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7 minutes ago, Morihalda said:

finish line finish line finish line!!

Don't Look Back!

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Alright, heading out of town for the Fan Expo this weekend (and Guardians of the Galaxy Vol.2!), so I might not be on very often, depending on my connection. Hold my calls and keep note of anything interesting while I'm gone, I'll check my messages when I get back

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1 minute ago, Pezler the Polychromatic said:

Alright, heading out of town for the Fan Expo this weekend (and Guardians of the Galaxy Vol.2!), so I might not be on very often, depending on my connection. Hold my calls and keep note of anything interesting while I'm gone, I'll check my messages when I get back

 

5 minutes ago, David Brawley said:

Don't Look Back!

 

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