DOCTOR: “Hello?”
CODER: “Hi Dr. Sri-Sheshadariprativadibayankaram, I need to talk to you right now.”
DOCTOR: “Well I’m in the middle of giving my patient CPR. Can’t this wait?”
CODER: “No, this is about coding our patient bill based on your documentation.”
DOCTOR: “What?”
CODER: “We can’t submit our charges for the patient you’re with right now until you respond to my online coding query. WHAT PART OF THIS DON’T YOU UNDERSTAND?!”
DOCTOR: “When did you send me the online coding query?”
CODER: “About 30 seconds ago. Why haven’t you logged on yet?!”
DOCTOR: “Because I’m in the middle of trying to save somebody’s life ri–”
CODER: “We are running out of time. I can do this verbally now. I was reading your progress note on the patient’s chart from this morning and you mentioned that he has a ‘hangnail’ requiring dilaudid for pain control in the Assessment & Plan section.”
DOCTOR: “Yes, he has a hangnail — WHEN WAS OUR LAST DOSE OF EPI?!!”
CODER: “Listen, I need you to focus on this now. I need more ICD-10 descriptors regarding the hangnail to maximize the charges. Was it acute, chronic, or acute-on-chronic?”
DOCTOR: “The hangnail?!”
CODER: “YES THE HANGNAIL! JUST ANSWER THE DAMN QUESTIONS!!!”
DOCTOR: “Acute.”
CODER: “What stage was the hangnail?”
DOCTOR: “There’s hangnail staging?”
CODER: “Forget it, I’ll just mark it as ‘unstageable’ for now.”
DOCTOR: “Was the hangnail malignant?”
CODER: “Malignant? I mean, I didn’t send it for biopsy.”
DOCTOR: “This is CRITICAL to assess the patient’s ROM [Risk Of Mortality].”
CODER: “Was the hangnail present on admission?”
DOCTOR: “Yes it wa–HOLD CHEST COMPRESSIONS! DO WE HAVE A PULSE?”
CODER: “Would you characterize the diagnosis as ‘hangnail failure’ or ‘hangnail insufficiency’ — we would strongly prefer the first choice.”
DOCTOR: “Fine, hangnail failure.”
CODER: “Does the patient have systolic or diastolic heart failure?”
DOCTOR: “Systolic. What does this have to do with his hangn–”
CODER: “Does the patient have severe protein calorie malnutrition?”
DOCTOR: “Yes.”
CODER: “Sepsis?”
DOCTOR: “Yes.”
CODER: “Present on admission?”
DOCTOR: “Sure.”
CODER: “Was this a ‘critical care hangnail encounter with dilaudid and lozenge dispensation’ today?”
DOCTOR: “Yeah, whatever.”
CODER: “So I’m going to submit this as ‘acute critical unstageable possibly malignant hangnail failure present on admission, complicated by systolic heart failure, severe protein calorie malnutrition & sepsis present on admission, with dilaudid and lozenge dispensation NOS’ now.
DOCTOR: “WHAT THE <expletive> is this <expletive> <expletive>?!!!” [call ends]
As of press time, Gomerblog has learned that the hospital, in order to maintain profit growth trajectories, has once again cut the pay for Dr. Sri-Sheshadariprativadibayankaram. And also the nurses. The hospital cut their pay too.
