Lame admit Dx's - page 2
Ever wonder how/why some can even be admitted? Maybe it's a small hosptial thing? One of our Docs admitted an old guy with: Fear of back pain. Does insurance even reimburse for that??... Read More
May 11, '02I'm in ICU and my favorites are the GI docs. They think everything should come to the unit. A little occult blood on a stool card warrants a type and cross for 10 units! They hate it when I am in charge. I say "what are the pts. vitals? What was that 130/70? What about pulse rate? 80 you say? What about their hemoglobin? 12? That's when I lose it and go off the wall. This patient doesn't even need to be admitted or seen in the ER let alone sent here! Those guys are out of control. Being a teaching hospital the residents say OK to the docs and then call me for the bed. I tell them no and if you want me to call the doc I'd be happy to. I can't believe how we waste unit beds and Tele beds and then when a legit patient needs one there aren't any available. Guess everyone is afraid of getting sued!!
May 11, '02How about.... STATUS ASTHMATICUS...????
A FAVORITE diagnosis of a doc I knew who practices in a small community hospital. (HALF of his pts were admitted with that diagnosis.)
May 11, '02FYI: My Dad died of CA a few years ago. Prior to his death, he started having siezures one Sunday morning. We called 911 because he wanted to live, and by God, I wanted him to live. (denial, anger, depression all in one lump for me) After we arrived at the ER, I told his doctor not to put him through anymore painful procedures and useless treatments if his cancer had spread to his brain. Let me take him to my house where I can keep him comfortable. Well it did, and he did anyway. The doc ordered radiation, this time directed to the brain. And it hurt my dad so much. And I hate. Some. Still not through the grieving process. sorry. But anyway. The reason why may be very innocent and understandable, if you care enough to find out. Don't be so quick to roll your eyes and categorize people.
You'll be surprised what you may find. Believe me, I was ignorant about healthcare and the human spirit until I went through the last stages of the life cycle with my daddy. Peace!
May 11, '02Pregnant patients who c/o vaginal discharge...................
30 minutes after having sex.
May 11, '02boobaby,
you don't think that i knew somone would be upset at my statement. i understand your point of view, i really do. it was not intended to put anyone down. i'm sorry. it just gets old after a while. ecspecially when the family tells them, don't call....just help him go as painlessly as possible.
May 11, '02Loved the pregnant pt w/ vag discharge 30 min after sex.
How about pregnant, anorexic- first request from patient was for bacod double cheeseburger, onion rings and a chocolate shake from burger king. Asked "thought you had trouble eating" Reply - "well, I don't have much of an appetite lately"!!
May 11, '02My personal favorite "Pt admitted for Social Admission" - the UR nurse was pitching a fit over that one.
I never knew that my floor was so entertaining, that it rated being a social event.
May 11, '02I do insurance coding. There are ICD-9 codes for some of these. These came from International Classification of Diseases 9th revision, clinical modifications, 2002 edition, printed by the AMA press.
Failure to thrive, adult - 783.7
Status asthmaticus - 493.9
Syncope (near) - (pre) - 780.2
Abdominal pain - 788.0
Cephalgia - 784.0
Intractable Vertigo - 780.4
Change in mental status - 780.9
Chest pain - 786.50 through 786.59
So far as the vag discharge after sex. It might depend on gestation. Sex is a great way to induce labor. Is she due, or is she at risk of premature labor and has ruptured membranes? Or is it the usual post- sex discharge?
Not being nasty, just being the Devil's advocate. There are ligit codes for MOST of those diagnoses. So, at least the doc isn't driving the coder nuts, and the insurance company (with it's clerks who have GED educations) will accept and pay for them. As you say , often they are not appropriate. Some docs do sound like broken records when it comes to making diagnoses, especially on the elderly. So, now I'll get off my soapbox.Last edit by judy ann on May 11, '02
May 12, '02My personal favorite was 'Patient is a social admission' - I thought the utilization review nurse was going to have a heart attack over that one!!!!
I also never knew that our unit was that entertaining to be a social event.
May 12, '02Rev Jessee Jackson is hospitalized for "muscle pain".
Who knows....maybe something serious but "sounds" bogus.