icdlist.com
One of my last UC shifts ever was where I had to go back into a room like 5 times because I aggroed some Karen and on one return visit she said she couldn't understand why I didn't take the time to "go over all of her individual medications and confirm how she was doing with them." I said that I had literally never done that with a patient in my life and that we don't do that in urgent care. I haven't worked urgent care in over 2 years now and my sanity has improved considerably.
That would have been a perfect moment for my favorite one liner: “We don’t do that here.”
Excellent reference.
Old? Heck, I'm seeing a ridiculous amount of them now. Every cough, cold, runny nose, sore throat, bump, nick, manscaping accident, muscle cramp, chest wall pain; ad infinitum ad nauseam. Apparently the concept of over-the-counter medications, band aids, and ice packs are completely foreign.
“Sir or madam, I went to a powerhouse residency that literally trained me to not care about that nonsense. Good day”
Unfortunately...Unacceptable as principle diagnosisICD-10-CM Diagnosis Code Z73.89 - Other problems related to life management difficulty
Z73.89 is a billable diagnosis code used to specify other problems related to life management difficulty. Synonyms: able to perform food and/or nutrition skill with
Marijuana hyperemesis in a gomer, brilliant...
Right. I used to use another Z code, which was "unspecified psychosocial circumstance". I was later told by a coder that using that Z code would, on a solid level 5 chart (like pedestrian struck), downcode it by one. So your solid 5 became a 4.
Insert "I can't even" meme.
I don't know. ICD? Gubmint?
I like the cut of your jib mate.
I present it to people in a collaborative way and they rarely argue. If they do. I don’t care. I order the tests and move on with my life. But I’d say legit 95% of the time they happily leave with no testing.
That’s a very respectful approach and a way I used to do it. Now I take the same approach as Genius. These patients will bog you down in questions and work any way they can to get something from you, whether that’s a duplicate test, an unnecessary prescription, or even just a social visit. We’re in a zero sum game these day and spending even 30 seconds with these patients takes 30 seconds away from another patient or makes me home 30 seconds later, both of which is unacceptable these days.
Yep. Punt em. I had a gastroparesis / vague and pain lady. Early 40s. Averaged 4-6 visits a month. Workup always benign. I was fortunate ate enough to get her two times in a row a while back. Both times I said "this is a chronic issue that we have proved we won't diagnose in the ER with any testing and coming back here routinely for IV meds of questionable benefit is not good for your long term health. We will no longer be providing any medication or doing any testing for this issue." Discharged her. She came back a week later and got me again and did the same. Now she's a regular at the ER a couple towns over.
This is the way.
This is the way. All ERs need to do this.
As an intern, a patient was discharged after a negative chest pain workup. He presented again 30 minutes later, to the same hospital and same attending, by ambulance. Before the nurse even sees the patient, the attending goes into his room, removes his IV, and tells him to leave.
I have in-laws in the FL panhandle. Can also confirm.
I concur but I love my life in Florida. Old people central but man if the chaos isn’t fun.
Sounds a lot like St. Landry Parish, Louisiana. My first weekend there working EMS, there was a horseback police chase. 2 guys came riding through our parking lot at full gallop with a PD cruiser chasing them.
