Medical Writing and a Day with Infusion coding....

As usual... i switched off my alarm at 5:30 itself... but... woke up at 6:15.... God... I am going to miss office bus... its a wonder how i manage to get ready... but sharp 6:35, i found my self dressed up in a black t shirt and favourite blue jeans and pair of sneakers...

Wearing my access card, locking door, running down stairs, and dialing ma friend, to know bus position, happened in less than a min's time... "Dude where are u?..... still not ready??????????" My friend yelled in the phone.. But... God's Grace, moment i am out of the gate, i found my driver stopping bus for me. 

Once in the office as usual, after a coffee from cafe, i am in training room again...

Its new module from today... Infusions and injections.

Moment i opened the chart in ma system, i was getting crazy...

I was about to call my proctor thinking that IT people loaded some kindergarten child's scrapbook in the system instead of a medical record of some unknown patient, treated by some unknown physician, in an unknown hospital in USA. 

"Stopppp.... Think Again..... Have u seen this type of charts before????? "... my mind is calling me.... oh yes..... these are our "nurses notes"... it took me back to my college days again.... 

I was feeling like the same old day; first day in my clinics, when i blinked looking at the bundle of papers in a blue file, which is so called "case sheets" of unlucky fellows lying on the beds just a glass wall away, to find out vital sign's column, when the staff nurse asked me to record it...

"Why cant these people write it in good way...? this is hell... cant read out a single line from this..."

i heard my co- worker  losing his temper...

They are paramedics, most of them deals with lab only.... All of them can read one line in every  chart " blood samples and urine send for examination"

I peeped to see what my Dr Co-worker is doing...... I found him lost in those scribblings in the so called "case file" trying hard to find out that "o" like structure is "a"; if so why cant they put a tag over that?, or is that "u", then why cant they open up the top portion completely?, or is that "o " itself?, then why cant they close it properly so that it wont look like "u or a". I think being a homeopathic physician he never took a look into an allopathic nurse's report.

Doubt for my biotech friend was that "d/cd" is "disconnected" or "discontinued" or simply "discharged"..... Question pointed to me..... Gosh.... She is expecting me to answer..... "Infact..... " i cleared my throat thinking what to tell, " well... it could be anything of these... depending on scenarios".... cheers to my trainer... those were her golden words, which i borrowed to tackle that situation..

Our trainer is lucky enough..... she is not in the scene yet.... other wise she will be forced to run around in the training room to unlock mysteries of "o" and "u", "d/cd" and "POs", "IVP" and "IVPB"...

Those reports were in fact horrible..... Only two of our team had exposed to handwritten "case sheets" as we both were nurses. And we, as nurses are supposed to read it fast and act up on that in clinics... But... here, we are just coders... " we think like a coder, we act like a coder"... I can understand how stressed those nurses when they wrote those cases in between heavy schedules, as i was a nurse once. But still guys.... " Document it properly.... so that we can help u in reimbursement...

What ever work or care they provided to patient, i could see how they  are losing money, as documentation lacks sufficient data for code to be assigned.

More than 6 charts were lacking enough data and proved no codes could be assigned... How pitty...

With much struggle, when i clicked submit all... i was relaxed.. at least i finished it...

But i saw down and stressed faces all around and my nurse colleague running around trying to help them by reading those charts.

i saw my trainer supporting her head in her hand, seeing the scores...

All have just once comment...." Document not clear....!" But guys... we are in coding and we have to learn it.... any way... it was time to wind up show for the day.... Discussion is scheduled for next day...

Back in bus heading home.... i found one of my colleague on my right side sleeping and other one in left side with a stressed face... " Whats matter dear?..." i asked....

"If this is what we need to handle, then i don't think i can make it up....." she replied...

Oh come on.... we are now out of office... even out of Technopark campus.... Relax dear.. u r still with the codes.....?

what ever its is... where ever we go....

All we have to think is about codes...

All we talk are about codes...

All we have to do is just... Code... Code.... and Code...

God help Us....

Mallu Jokes....

1) What is the tax on a Mallu's income called?

* IngumDax *

2) Where did the Malayali study?

*In the ko-liage.*

3) Why did the Malayali not go to ko-liage today?

* He is very bissi. *

4) Why did the Malayali buy an air-ticket? *To go to Thuubai, zimbly to meet his ungle in

Gelff.*

5) Why do Malayalis go to the Gelff?

*To yearn meney. *

6) What did the Malayali do when the plane caught Fire?

* He zimbly jembd out of the vindow. *

7) How does a Malayali spell moon?

*MOON - Yem Who yet another Who and Yen*

8) What is Malayali management graduate called?

* Yem Bee Yae.

* 9) What does a Malayali do when he goes to America ? *He changes his name from Karunakaran to Kevin

Curren.*

10) What does a Malayali use to commute to office Everyday?

* An Oto

* 11) Where does he pray?

*In a Temble, Charch and a Maask*

12) Who is Bruce Lee's best friend ? * A Malaya-Lee of coarse.

*

13) Name the only part of the werld, where Malayalis don't werk hard?

* Kerala.

*14) Why is industrial productivity so low in Kerala? * Because 86% of the shift time is spent on lifting, folding and

re-tying the lungi

* 15) Why did Saddam Hussain attackKuwait? * He had a Mallu baby-sitter, who always used to say

'KEEP QUWAIT' 'KEEP QUWAIT'*

16) What is the Latest Malayali Punch Line? * " Frem Tea Shops To Koll Cenders , We Are

Yevery Where " *

17) Why aren't Mals included in hockey and football Teams ? * Coz Whenever they get a corner , they set up a tea

shop.

* 18) Now pass it on to 5 Mals to get a free sample of

* Kokanet oil.

*19) Pass it on 10 Mals to get a free pack of *Benana* * Chibbs.

*

20) Pass it on to 15 Mals to get a set of *BROGUN*

* Bones....*

21) what do u call a very creepy mallu---

CATTER PILLAI

22) what do u call a sexy mallu

DEBO NAIR

23) what do u call a intelligent mallu

PHENO MENON

24) what do u call a very young mallu

MONE

All i have to do is code... code....code and code.....

Lost words..... infact lost in the world of codes.......... ICD PDX, PPX, SDX, CPT, HCPCS, modifiers, V codes, E codes, up code, downcode, bundled codes blah blah blah..... Just four months into Medical coding..... Brain is like full of codes..... even though still make errors..... I wonder how the way of talking also changed..... Did Nursing for four years, but never felt that i am talking in medical language... But just finished four months in coding... language changed... When my mom tells that she is having fever and took medicine, what i am asking is Modifier TC or modifier 59.... or like technical component or professional component.... ( instead of asking doctor prescribed medicine or her own treatment??).... infact if i didnt ask also, its sure my mouth will open to ask... When i asked for an access card.... i asked to security desk..." may i have a code??"... shit... code or card???? which was like some nitrogen bomb exploded...laughing gas spread over there... When my friends ask me why i didnt ask about the payment to manager..... Instead of telling them " no one ask me to do that", i prefer to tell" if it is not documented... not done... and not coded" When my girl friend complains that she expected me to be there on her birth day... instead of saying "just dream it" i would say..." Never Assume in coding" When my Dad explains about his dreams about my future and earning a 6 digit salary and driving home a Toyota Prado.... I would say" Think like a coder" World of codes.... are with full of guidelines, cross checks, clinical references.... and of course multiple codes or wrong codes to give us negative scores.. Same way or life.... full of norms and guidelines and laws.... and bonds.... But to code a medical chart, we have Encoder, guidelines, websites, reference, CPT and ICD books and our supervisor.......... But to code our life... there is only one tool...just love..... and no supervisor....... just you....

New Place, New Job, New People.....

Its been so long that i wrote something here..... Problems in social life made me to keep quite most of the time, atleast to prevent me from losing my temper. Last post was in Jan this year.... After that this is the first time that i am sitting in front of the moniter loaded with blogger page. "Life is not so easy.....", this is what my room mate in Bangalore used to tell me. " Profession which u took really needs hard work.." and this was the advice form my professor. Any way, with past six months of dormancy, i realised many sides of the big fact called life.... When i got my results i was like in the top of the world, thinking that my life is settled..... But walking up and down in Bangalore city looking for a job forced me to think about shifting to some other city..... Why cant it be to the "Queen of Arabian Sea", our great Cochin????? No son..... ist not so easy...... that was the reply form my loving dad..... His advice was to move to Trivandrum. Again the problems were waiting for me, the guys who are sitting in the Chair of Administrators or the people we call as Doctors wants me to work for Peanuts..... Big no..... Why should i? If its for a Charitable hospital, will think....  And my Neighbours, even my own Grandmother started to get me in trouble.... asking "why u r not going for work?????" It was that time i thought about a new carrier.... And i found that in a malayalam daily..... And i am in a new place now..... With new people, learning anew Carrier.... Medical Coding.... This is new way for me, but so far i am comfortable..... Still one more month to finish my training to be a professional coder... New People around me, new atmosphere, and this new city... I feel life is back in track again.....

Power Cut again..... Ohhhh...nooo......

Kerala electricity department minister announced LDF government's new year gift for GOD'S OWN COUNTRY..... Half an hour powercut from tommorow......

Again.... for the small tail like state of the sub continent day reduced to 23 and ahalf hours instead of 24 hrs like rest of world.... But why?

Couple of years before when the power cut were a part of average keralite's( simplified as mallus)life, Government's excuse was that there is not enough water in the Dams to produce elctricity... For a state which depends on hydro electric power projects to meet its electrical needs those were acceptable. When projects like combined cycle thermal power paln in kayamkulam, diesel power plants were commissioned, God's own contry hoped that she can restore the day back as 24hrs. But nothing changed... Kerala state Elecricity Board remained as the worst managed and worst corrupted Electric company in the sub continent. As a part of achieving dream of 24 hrs power supply for kerala cities like Trivandrum, Cochin and Calicut were excluded from the 30 mins power cut as an initial step and shortly spreaded to the whole state.

What happened now? is that water scarcity? this year? may be this was the year rain gauges in the state recorded its highest level of rain fall.... so water scarcity cannot be the made as an excuse this time... so this time its technical problems.... Why just wondring about Electricity board?

Roads, hospitals, Government offices, Courts, Police stations, schools, colleges not even temples in the state is not fuctioning properly. Still ministers are active in fighting each other and giving shouting like idiots..... where we are going... executive and judiciary is failing because of its counter part legislature is failing to work together.... who knows where we will reach...

Only God can help his own country.....