Monday, July 30, 2012

Code for the Day: Unhappy Monday R45.2

There is a local radio station here in Denver with a deejay whose pet peeve is people complaining about Mondays.  "It's just another day of the week people," I've heard him say more than once.  I'm pretty much an optimist and don't like to get dragged into the Monday doldrums myself, but it is harder for me to get going on a Monday morning. And so I often tag a "Happy Monday" note with a smiley face on emails on Monday mornings.  It's not as much for the recipient - although if it helps them, then yay! - but for me.

So I was trying to decide what kind of code to choose for today and I've had this one jotted down on my virtual post-it for about a week:

  • R45.2 Unhappiness
When I first came across that code, I did a double take.  Did I really just see a code for being unhappy?  Seriously?

In case you're wondering, this code is found in Chapter 18 of ICD-10-CM, Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified.  In other words, it's a symptom code.  Whew!  Thankfully it's not in the mental and behavioral health chapter!  But I, personally, think something is missing here - a couple of nonessential modifiers.

Quick side note for you newbies (and the veterans who have forgotten):  Nonessential modifiers are those words in the index and code descriptions found in parentheses.  These parentheses enclose words that may or may not apply to the patient you are coding.  In this case, I think the following list of nonessential modifiers should be added:
  • Temporary - This could apply to all of us at one point in time or another.
  • Persistent - Seriously.  I know persistently unhappy people.  I've found there are two options: 1) Try to make them smile (or better yet, laugh!); and 2) Stay away.  Persistently unhappy people can be toxic.
  • Monday doldrums - Self explanatory.
  • Monday blahs - See "Monday doldrums"
  • A case of the Mondays - See "Monday doldrums"
Those are my recommendations anyway.  I have many more pressing letters to send in to the Coordination and Maintenance Committee regarding ICD-10-CM coding questions and issues, so I will refrain sending them my ideas for nonessential modifiers for code R45.2. For now. 

So from me to you, I would like to wish you a Happy Monday.  And if you were an R45.2 this morning, may it be temporary.  And here's something I learned from my mom - smiley faces are contagious.  Here's one for you!