Newsflash: The AMA is Fighting ICD-10 - is my Blog to Blame?

Okay, so it's not really news that the American Medical Association is showing R45.4 (Irritability and anger) and R45.5 (Hostility) when it comes to ICD-10.  But are their R45.82 (worries) really worth all the R45.83 (Excessive crying of child, adolescent, or adult)?

Okay, all kidding aside, I hate to admit that blogs like mine might be partly to blame for the backlash, but are they?  In learning ICD-10-CM, it's just not fun to write blogs and articles about how the ICD-9-CM code for unspecified hypertension will be I10 in ICD-10.  Okay, bad example.  ICD-10 gives us I10 (hypertension).  Oh wait, you've heard that one? 

I'll go out on a limb here and just say it.  Coding is boring.  But I love it anyway and find it fascinating and go out of my way to try to make learning coding fun and enjoyable.  And since in my day job I don't get to spend a lot of time reflecting on the fun and entertaining external cause codes, I have decided to take to my blog to explore some of the more entertaining ICD-10 codes and inject some humor where I can.  And it's hard.  Because, as I mentioned, coding is boring.

But with all of the hype on ICD-10 we've managed to fool a lot of people into thinking that it's not really boring no-nonsense work and that what we do is actually very trivial and unimportant.  In an April interview on Fox News, Congressman Ted Poe (R-TX) gave several arguments against ICD-10-CM implementation in the United States and several examples of why the new coding system is ridiculous and unnecessary, including the various codes for injuries by turkeys and dog bites by specific breeds of dogs (BTW - dog bites by breed codes do not exist). 

Indeed, there are some very silly external cause codes, but in an article by the American Health Information Management Association, which wasn't as well publicized as Congressman Poe's interview, AHIMA states that there is no national mandate to report external cause codes in ICD-10-CM.  In fact, if providers are not reporting E codes in ICD-9-CM, they won't be required to report external cause codes in ICD-10-CM.  And since the 1500 billing form, which is used by physicians to report codes to Medicare, only has space for four diagnosis codes, the external cause codes are not likely to play a large role in pro-fee coding and billing.  And then all that's left is those boring codes in the remaining ICD-10 chapters.

But why isn't anyone pointing that out?  Well, I suppose it's just more fun to talk about a code for being pecked by a chicken.  Or struck by a chicken (is that a live chicken or, say, a frozen chicken from the supermarket?!).  But in reality, we are training coders on the important enhancements that ICD-10 coding brings.  Here are a couple of important "for instances" for you:

• Somewhat simplified sepsis coding (okay, so they couldn't do it all, but we'll take somewhat simplified over super confusing any day)
• One diagnosis code for admission for vaccination (the procedure code indicates the specific vaccine given)
• OB codes that actually make sense - most of them classify conditions by trimester rather than that "delivered with antepartum complication" nonsense
• New and specific codes for subsequent acute myocardial infarction (AMI) that occurs within the timeframe of an initial AMI
• Codes for blood alcohol level (here in Colorado we're waiting for the blood marijuana content codes - I'm pretty sure Washington is interested too)
• Bye-bye to encounter for therapy codes (talk about administrative burden - insurance companies hate those V codes for admission for physical/occupational/speech therapy codes; the new code system has a way of denoting that an injury is in the healing phase)
• Combination codes for diabetic complications (because half the time coders forget to code the second code anyway)

Now don't get me wrong.  I am not saying that physicians won't be impacted at all because they will.  We will be asking them to document more clearly but in general we want documentation that really should already be there.  It's nice to know whether the left or right femur is broken.  I'm pretty sure that it's not just the coders who are interested.  And even though physicians won't have to code ICD-10-PCS procedure codes, we will be prompting them for more specific documentation within operative reports. 

And while we're at it, let's talk about the volume of codes.  Yes, there are a lot more ICD-10-CM codes than ICD-9-CM codes.  That's to be expected when they create codes for left, right, bilateral, and unspecified where applicable.  And my favorite quote regarding this issue came from Don Asmonga of AHIMA at a conference last spring: "There are a lot of words in the dictionary, but that doesn't mean you use all of them."  Indeed.  There are many codes that we will never use.  And coders aren't supposed to memorize codes anyway.  In the training I've done thus far, coders have actually expressed that having more codes is better - they are able to better drill down to what's really going on with the patient instead of sticking a junky nonspecific code on the case.

So if you come across a physician who is arguing against ICD-10 implementation, I would suggest that you put the kibosh on the fun code talk and get straight to the boring benefits.  Will ICD-10 impact patient care?  Probably not as directly as nurse finding a medication error before meds are administered.  But the data that is collected on the back end will have implications for future quality initiatives; in fact many of the quality initiatives coming up depend on ICD-10 data.  Besides, even the boring ICD-10-CM codes are more exciting than the same old boring ICD-9-CM codes that no other industrialized nation in the WORLD uses anymore.  I mean, I hate to play the peer pressure card, but seriously, we should be leaders in in medicine - and in collecting medical data.  Who else is on board?

How I Spent My Summer, by the Coder Coach (Y93.E6)

I really don't care if I ever see another cardboard box as long as I live.  After a summer of botched real estate closings and not one, but - count them - two moves spaced two weeks apart (complete with my office and two cats), I think I've arrived in my new home with everything except for potentially my sanity. 

I'm not sure which was more foolish - deciding to move the summer before we enter the home stretch of the last year before ICD-10 implementation or deciding to plan a wedding that will occur just a couple of weeks before ICD-10 implementation.  Just for good measure, I decided to do both.  The comforting thing is, ICD-10 is still there waiting for me even after the dust has settled from all of those cardboard boxes and I never did lose sight of my ICD-10 codebooks during the move - er moves.  In fact, my training calendar is booking up fast between now and September of next year!

I was pretty excited to find that there was indeed an ICD-10 code to describe how I spent my summer:

• Y93.E6, Activity, residential relocation

This code includes packing up and unpacking involved in moving to a new residence.  I wish there was a code for hernia acquired by moving boxes of code books.  I swear those things multiply like rabbits.  And for the record, I have informed my fiancé that we are never moving.  Ever. Again.

The Great Cat Extraction - 10D07Z8

I've been spending the last couple of months training clients on ICD-10-CM and ICD-10-PCS and one of the things I love most about it is that I continue to learn more about ICD-10 and it's getting easier.  As a matter of fact, I now feel more qualified to teach ICD-10 than ICD-9.  But of course, I could pick ICD-9 back up again quickly if I had to.  You can't erase nearly two decades of experience overnight!

Many who know me well and have sat through my training sessions know that I like to teach by analogy (much the same way this blog is written).  So when I unpack my laptop and training materials at a client, I also unpack a series of stories, jokes (well, I think they're funny), and tricks to remembering all the knowledge that I'm about to lay on them.  Probably one of my favorites is the Great Cat Extraction, which I was reminded of yesterday when I took my sweet little Mandy to the vet.

My cat Mandy is 6 petite pounds of pure purring pleasantness.  Until you try to get her into her pink fluffy carrier to go somewhere.  Then she develops the will and strength of an Olympic wrestler and I'm still not quite sure how it happens, but the neck arches back and in true cartoon form, her extremities extend in all directions so that she resembles a star.  Try shoving that into a carrier.  And yesterday when we got to the vet, I thought I would be clever getting her out and unzip the top of the carrier.  No go.  Somehow, she buried her head into a corner and it kept getting caught as I tried to pull her out.  Poor kitty.

You may be wondering what the heck the Great Cat Extraction has to do with coding.  Well, it comes up in our discussion of the root operations Delivery and Extraction in the Obstetrical section of ICD-10-PCS.  The root operation Delivery is defined as, "Assisting the passage of the products of conception from the genital canal," or more cleverly, simply defined as "catching the baby" without the use of instrumentation or manipulation.  The way this was described to me is that the baby is going to come whether the doctor or midwife is there to catch it or not.  There is only one code in the Delivery table: 10E0XZZ (I still think that looks like a license plate number). 

The root operation Extraction, on the other hand, is defined as. "Pulling or stripping out or off all or a portion of a body part by the use of force."  Okay, first: ouch.  Second, if you look at the options for this table, which I've pasted here below for you, you will see that Extraction includes everything from cesarean section (the row that includes Open as the approach) to vacuum extraction (the row that has Products of Conception as the body part and Via Natural or Artificial Opening as the approach) to dilation and curettage (the last row, which has Products of Conception, Retained and Products of Conception, Ectopic as the body parts). 

Normal position for a fetus at the time of delivery is head down, but some babies are breech.  Version is usually attempted on breech babies to turn them into correct position, but they can be delivered in breech position with some finesse.  But a breech extraction is by no means a normal or simple delivery.  Trying to get the baby's limbs to deliver without injuring it or getting caught is very much like the Great Cat Extraction.  The code for a breech extraction is 10D07Z8 - this is assuming that no internal version was performed.  So when you think breech extraction, think Mandy the itty bitty kitty with the strength and limb extension of a gymnast.

 By the way, everything came out okay at the vet.  Including the cat.  Eventually.

Is ICD-10 Giving You F41.0 (Panic Attacks?)

Is it just me or is the amount of ICD-10 hype particularly increased over the last couple of months?   Now, at just 17 months until implementation, it seems the industry has taken it up a notch lately.  And that has me wondering if ICD-10 is giving anyone panic attacks yet.  And yes, there is a code for that:

• F41.0, Panic disorder [episodic paroxysmal anxiety] without agoraphobia

At least I hope no one has been moved to the point of panic where they are afraid to leave their homes.

As for me, I have been eating, sleeping, and breathing ICD-10.  In my day job, I've been writing training materials and even delivering training to clients.  On Colorado's ICD-10 Task Force, we've just planned a year's worth of statewide education.  I've given up a Saturday or two to attend or facilitate ICD-10 Coffee Chats locally for roundtable discussions on coding in ICD-10.  And I've hit two regional associations here in Colorado and given an hour long presentation to each on what's happening with ICD-10 on the state level.  On a daily basis, I receive at least 10-15 newsletters or marketing emails on ICD-10.

No wonder I find I have CPT amnesia.

At any rate, is it just me or are you feeling it too?  I've been looking for a new hook for my blog for 2013 and I think I may have found it, so look for upcoming blogs on some creative ways to navigate the onslaught of ICD-10 information.  Who has the most precise and condensed information out there?  Where can you get affordable (or free) ICD-10 education?  Where can you download and begin learning ICD-10 on your own?  All this and more as I eat, sleep, breathe... and blog about ICD-10.

Code for the Day: It's All About Heart (I21.-& I22.-)

I am not a fan of Valentines Day.  And please don't mistake this for bitterness, I just find it ridiculous that we have a holiday dedicated to telling the ones we love that we love them when there are 364 other perfectly good days in the year to confirm the sentiment.  So I really just see Valentines Day as an excuse for my grocery store to mark up the cost of roses for 2 weeks in February.  And let's be real here: I hate the combination of pink and red hearts.  I don't know what it is, but it makes me queasy.  Pink hearts alone are fine.  Red hearts alone are dandy.  But together, ick.  And it get even worse when they throw in those purple hearts for good measure.

As I sit here with my pink heart necklace - after all, I am a festive person and there are no red hearts in sight - I do like Valentines Day as a reminder of something more important: February is American Heart month.  Maybe you "go red" on Fridays or wear a red ribbon.  Maybe you take the month to become more educated on heart disease and the warning signs of a heart attack.  Today, I think we should definitely focus on ICD-10 coding for myocardial infarction!  So consider this my valentine to you: a short tutorial on what to expect in ICD-10 for coding myocardial infarction.

The first thing you need to know is that the definition of an acute myocardial infarction (AMI) has changed.  It is no longer one that has occurred within the past 8 weeks, the period is now reduced to 4.  You also no longer need to know if the AMI episode is the initial or a subsequent encounter for treatment.  In fact, forget everything you know about coding AMI in ICD-9-CM because it will just confuse you in ICD-10-CM.  Here are the highlights:

• The new period for an AMI is 4 weeks
• The terms ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) are now part of the code titles, not just inclusion terms for the codes
• AMI codes to two categories: 
• I21, ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction
• I22, Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction
• Additional characters report the specific site of the AMI (heart wall or vessel)
• Sequencing depends on the circumstances of admission

The key to knowing when to use a code from category I21 versus one from category I22 is not when the patient receives treatment, but for which AMI he is receiving treatment for.  

Let's take an example.  Bob comes in February 14 with a heart attack.  This is so tragic for Bob's wife, who did not get her roses.  For this Valentines Day visit, we assign a code from category I21 for an initial AMI.  This is the first heart attack Bob has had in the last 4 weeks.  

Let's say Bob comes back on his anniversary, February 28 with a second heart attack. I'm really starting to feel sorry for Bob's wife.  Oh, and Bob too. For this second visit, we would assign a code from category I22 to show that this is a subsequent heart attack that occurred within the 4 week period of his initial heart attack.  You would assign a code from category I21 as a secondary diagnosis to report that first heart attack on Valentines Day.

As for sequencing, notice in Bob's case, I22 was put first on the second visit since it was the reason for his admission (after study, yada yada).  But what if Bob had been admitted for that first heart attack on the 14th and experienced his second while he was an inpatient?  In this case, the I21 would be sequenced first with I22 as a secondary.  Again, sequencing depends on the circumstances of admission.

I'll just let that sink in a bit.

Have a healthy and happy Valentines Day and enjoy the ones you love.  And if you must indulge, might I recommend some antioxidant chocolates and heart-healthy red wine?  Stay away from those overpriced roses!

Code for the Day: Let's Hope Steamboat Springs' Lighted Man Never Sees This on a Claim Form

I just spent a very fun weekend in Steamboat Springs with my boyfriend visiting his family.  For the second year in a row, we decided that the prime weekend for a visit was during Winter Carnival, which is pretty spectacular if you ever have the chance to witness it.  During the day, they load up Main Street with snow for events such as the donkey jump, where local cowboys saddle up their horses so they can drag kids on skis over ski jumps (something my boyfriend has experienced and survived) or the shovel race, where the cowboys drag "grown" men sitting on snow shovels down the street to see who can get the best time.

There are lots of other things going on as well.  Last year, we went to Howelsen Hill - home of the Steamboat Springs Winter Sports Club and training ground of many Olympians - to watch some ski jumps.  But perhaps the biggest draw is Saturday night's fireworks display and the Lighted Man.  This show begins after dark at Howelsen Hill as skiers carrying flares make their way down the mountain.  Cut your eyes to the right, and you will see ski jumpers with flares jumping through a ring of fire.  But the grand finale is always the Lighted Man - a skier outfitted in a suit of LED lights making his way down the hill while fireworks shooting from his body.

As for me, since I don't downhill ski, I spent the weekend running barefoot through snow-lined walkways from pool to pool at the hot springs, traipsing through a man-made ice castle, and giving cross country skiing a try. There were so many options for a code for the day, but I kept coming back to the Lighted Man.  Because codes on a claim tell a story, I just wonder what the insurance company would say should the Lighted Man have to report these codes:

• W39.xxxA, Discharge of firework, Initial encounter
• Y93.23, Activity, snow (alpine) (downhill) skiing, snow boarding, sledding, tobogganing and snow tubing

It's such a fun tradition, I hope he never has to find out. I didn't get close enough to the mountain this year to get a good pic of the Lighted Man, but if you'd like to see some great pictures of the Winter Carnival is like, there is a good synopsis if you click here.

Article Review: The Coder Coach Responds to "Industry Disconnect"

I'm afraid today's topic won't be quite the entertainment fodder that many of my readers have come to enjoy because this is a serious topic and one that I am very passionate about. And it deserves a serious blog posting!  Someone recently asked me on my Facebook page what I thought about a recent cover story published in For the Record Magazine.  "Industry Disconnect" by Selena Chavis is a great read for anyone who has been pounding the pavement looking for a coding job.  It is also a must read for any coding professional with hiring power.  In short, this article highlights the biggest threat to the future of the coding industry: the ability to hire, mentor, and train recent grads.

It's no secret how I feel about mentoring our future workforce.  My thoughts are well documented throughout the Coder Coach and my colleagues in the state of Colorado know how outspoken I am about the topic of mentoring coders.

So when I was asked, I thought, wow, what a great topic for my blog.  Here are my thoughts on the article: it illustrates an accurate, although bleak, outlook on the future.  But all is not hopeless.  This article has some great points, but it also brought to mind some myths about coding mentoring and training that I would like to address.

Myth 1: There is a disconnect between coding schools and employers and no one cares or is doing anything about it
Partially true.  In general there is a disconnect between schools and employers, as documented in the article.  It is not true that no one cares.  Hello!  Are you reading my blog?  I currently sit on Colorado Health Information Management's Student Alliance Task Force - a mouthful, I know!  This is an alliance made up of CHIMA members and directors from the local HIM schools and we spend our time trying to figure out how to get better and more meaningful internship experiences for students.  There are a ton of road blocks and we are trying to decide how to break them down.  More on that in a sec.

Myth 2: Hospitals will only hire people who can hit the ground running
I hate this myth.  Because, in my experience, there is no such thing as a coder who can hit the ground running.  Okay, that was deep.  Let me repeat with more emphasis,  there is no such thing as a coder who can hit the ground running.  It's true that new grads take more time and as the article mentioned, there is only so much you can teach in a 2-year program that will prepare people for a future in electronic medical records, privacy and security, coding, cancer registry, and the list goes on.  It is unrealistic to expect new coders to be able to hit the ground running and it's ridiculous to exclude new grads thinking they won't have anything to offer.  I have never hired a coder - novice or experienced - who didn't need on the job training.  It's true that you can teach an old dog new tricks, but it's equally true that old habits die hard.  A new coder may not have experience, but as Linda Donahue, RHIT, CCS, CCS-P, CPC mentioned in the article, it is easier to teach new habits than correct old ones.  If you can absorb information like a sponge, you may have a serious future in coding.

On a side note, I decided to test this no-such-thing-as-hit-the-ground-running theory, so I called up my friend and newest coworker, Sandy Giangreco, RHIT, CCS, RCC, CPC-I, PCS, COBGC, CPC, CPC-H and AHIMA-Approved ICD-10-CM/PCS Trainer (are you getting the impression that Sandy has a little experience?!).  I asked her if she felt like she'd hit the ground running and she said sort of.  Now keep in mind that Sandy has many years of excellent coding experience (and a couple certifications!) and was hired by Haugen Consulting Group as a Senior Consultant.  We don't have to teach her how to code.  But she is trying to get used to our way of doing things and our training materials so that she can further develop more materials and peer review other content.  She is not up to speed yet.  But it's only like her second week, so I'll cut her some slack!

Myth 3: If hospitals take the time to train people, they will just leave and take those skills elsewhere
Oh waaaa.  Oops, did I type that out loud?   This is something that industry leaders need to get over.  We no longer live in an era where people pledge allegiance to a certain company and stay there for 30 years and retire to a blissful lifestyle at the age of 62.  When I got my first coding job, my manager and mentor, Lila, told me she knew she wouldn't be able to keep me but she wanted to give me an opportunity.  And I am so thankful she did.  There are other Lila's out there who are willing to train you so they can have a hand in training the future workforce as a whole - not just at their own institution.  I think if more people adopted this mentality, the future of the coding field would be bright indeed.

Myth 4: No one is willing to train on the job
So it turns out Lila was right.  I worked for her for three years before taking a job as her peer coding supervisor at a sister hospital.  And then she moved on for another career opportunity outside our hospital system.  That was 15 years ago.  Recently our paths crossed again when Lila took a management position with one of my clients.  Last fall I got to travel with her during a training trip and it was so much fun to be back in the company of that person who first gave me a start.  And I was dying to ask her: if you could do it all over again, in today's climate of EMRs and code-based reimbursement, would you hire a green coder like I was back in the day?  And she said yes.  Here it is almost 20 years since she gave me a chance and so much has changed with coding and HIM and she still feels the same way about training and mentoring.  God bless Lila and every coding manager like her.  We also have a hospital system in Colorado that recently opened their own coding school in preparation for ICD-10 and they are accepting people with baseline coding class experience and placing them into coding positions at the end.  People are willing to train, you just have to find them.

Myth 5: Experienced coders know more
Okay, so this may be where I lose some loyal blog readers and for that I apologize.  I will start by saying that I know some really smart, terrific coders who can code like nobody's business.  And as a coding trainer, I also know a lot of "experienced" coders who don't know as much as they think they do.  At Haugen Consulting Group, we actually have a training program for experienced coders about coding basics or fundamentals where we get them back to the coding guidelines.  Because they forget.  They get so caught up in the details that they can't see the forest between the trees.  And it's not really their fault.  My point is, new coders may have an advantage here - we are trying to get coders back to the guidelines and most students know nothing but those guidelines.  They are also "closer to the books" when it comes to things like anatomy and physiology.  And I cannot stress enough How.  Very.  Important. This. Will.  Be. For. ICD-10.  No coder knows everything - it's impossible.  I learn more about coding every day and I teach the darn stuff.  That's actually what I love about it.

Myth 6: Coding students can't get hands-on experience because of EMRs
There is some truth to this.  I hate that word "can't," though.  When I did my internship I reported to the hospital every day for 3 weeks like it was my job.  There was a coding unit and all the coders sat together.  I understand that that hospital no longer has a coding unit.  The coders all work from home by accessing the electronic medical record (EMR).  And that's how most hospitals are these days.  It's not impossible for students to get hands on experience, but it is challenging.  The main road block here is HIPAA.  The Health Insurance Portability and Accountability Act of 1996 allows for electronic submission of health information and as HIM professionals, we understand the confidentiality and security issues surrounding protected health information (PHI).  As HIM professionals, we have a duty to keep this data confidential but we also have the duty to train new professionals.  We are trying to find ways to bust this excuse, but our first commitment is to the patient and protecting their data.  That's just something to think about when you complain about the background check you need to go through to get access to a system as a student.  How would you feel if it was your medical record?

Myth 7: There are not enough coding jobs for students
Bologna.  I've said it before and I'll say it again.  There may not be a bunch of jobs for "coder," but there are tons of jobs that are coding related.  Stop searching for coding positions in HIM departments and ending your search there.  Start looking for jobs that have ICD-9-CM and CPT embedded in their job descriptions.  You will learn more than you think just by being around codes.  Plus, if you can get a job in billing, this is a great place to see coding reimbursement in action.

Wow, this is already way longer than I intended, so I will leave you with this.  I love that Ms. Chavis's article was the cover story.  I think this is the most critical issue facing our industry today (even more so that ICD-10!). But I don't want you to walk away from this article thinking that a future in coding is futile.  Get out there and network!  People give jobs to people they know, so go out there and get known!

If you haven't found a job in coding, ask yourself if you've exhausted every option.  I meet all kinds of people who want to be coders for all kinds of different reasons.  If you want to be a coder only because you want to work from home, stop now.  You won't be successful.  But if you want to be a coder because you love the detective work you have to do to pull documentation together to get those codes, then there should be nothing on this earth that will stop you.  I see a lot of people making excuses about why they aren't getting coding jobs, but I firmly believe that if you want it badly enough, you will get there.  I'm no stranger to excuses myself - mostly when it comes to living a healthy lifestyle.  So lately, I've been carrying around this quote as a reminder any time I catch myself making an excuse and falling into the role of victim:

"Ninety-nine percent of the failures come from people who have the habit of making excuses."
-George Washington Carver

I am willing to work with my colleagues to remove the excuses about why we can't train and mentor.  Are you willing remove excuses for any of your own roadblocks that you've put up?

Code for the Day: There's Even a Code for One of My New Year's Resolutions! (Y93.E9)

How do people start New Year's resolutions on January 1?  Am I the only person in the world who bakes, entertains, gift wraps, and parties myself into oblivion until the point where I don't want to do a darn thing come New Year's Day?  Here we are on January 14 and I am finally getting things organized enough to focus on how to better myself in 2013. 

Oh sure, I had lofty goals.  Last year, we took an awesome New Year's day hike at Red Rocks Park near Denver.  And we were going to do it again.  But this year 2013 hit us in a sleep deprived state so we decided to forgo the hike and head to a late breakfast instead.  We did end up at Ikea, though, so I suppose a few hours there could technically be classified as a hike.

In general, I hate New Year's resolutions.  I think they are incredibly cliche and what's even more cliche is the fact that they never last.  I think the number 1 New Year's resolution should be to make your New Year's resolution last longer than a few weeks - maybe even the whole year. 

I try to start out every year with a general plan to get organized and unload myself of unnecessary clutter. I am, after all a super organized coder and that carries over into my home and daily life. So I've spent the last couple of weeks organizing my kitchen, planning menus, organizing closets, cutting back on what I eat (duh, who doesn't have that resolution!), and decluttering my physical space.  And I was so delighted to find that there is, in fact, a code for that:

• Y93.E9, Activity, other interior property and clothing maintenance

If only there was a companion code specific to shoe shopping - then I could code the before and the after!

What's in Store for 2013?

Happy New Year to all of you!  I am not sure what is in store for my blog in 2013, but I continue to look around for inspiration. For now I am still inspired by the Code for the Day, even though it doesn't seem to come every day. Look for an FAQs page coming some time in the next couple of months for people interested in a coding career.  And best wishes for keeping your New Year's resolution past first quarter!