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

  • 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

7:25

  • 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

PLACE OF OCCURRENCE STREET AND HIGHWAY ICD-E849.5

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

8:45-12:00

  • 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

Note: This is a caricature, not my real life.  My wife and kids are generally very nice to me and I do like my work.

52 Comments