Twelve Codes of Christmas: On the Sixth Day of Christmas (G30.9, F02.80)

Christmas only a week away and there is something sorely missing from the scene here in Denver... Snow.

If you don't live here, you may have heard that Colorado is getting snow.  But the truth is, we haven't had much snow down in the city.  Although Denver is a mile high, it sits in a valley - lower than surrounding regions and much lower than the mountainous regions with peaks rising to 14,000 feet.  Snow in the mountains is good news for the ski resorts and our low reservoirs.  But in Denver, we've had weather well into the 60s in December.  And here I am still dreaming of a white Christmas.

I am considering trying to conjure one up by watching endless reruns of White Christmas.  Maybe Bing Crosby and Rosemary Clooney can work some white magic in Colorado in 2012 like they did in the 50s in Pine Tree, Vermont.  Or maybe I should put the Nitty Gritty Dirt Band's "Colorado Christmas" on endless repeat on the iPod. 

So in an attempt to help things along a bit and get me one step closer to walking in a winter wonderland this Christmas, on the sixth day of Christmas, here's our carol:

• Walking in a Winter Wonderland Miles from my House in my Slippers and Robe (G30.9, Alzheimer's disease, unspecified and F02.80, Dementia in other diseases classified elsewhere without behavioral disturbances)

Twelve Codes of Christmas: On the Fifth Day of the Coder's Christmas (F22)

When I was a kid, the idea of Santa Claus coming on Christmas Eve and dropping off presents was both exciting and perplexing.  We didn't have a chimney and being the inquisitive type, I remember never getting a satisfactory answer as to how Santa got in the house.  I believe the word "magic" was thrown around a lot and I guess I figured if he knew everything, then he also knew how to get into the house.

And even though I begged to go see Santa at the mall when I was little, I don't think I have a single picture of a happy me sitting on Santa's lap.  The closer we got in line to the big jolly fellow, the more uneasy I felt and  when they perched me on his lap, I don't think I ever felt like this was someone who knew me well, he was just a stranger.  As an adult, I finally get it.  Santa is creepy.

I mean seriously.  This is a grown man who knows where you live, if you've been good or bad, and he sneaks into your house while you're sleeping.  There's a word for that: stalker.

So if you've ever felt a little uneasy about the oversized jolly old elf, this carol on the fifth day of the coder's Christmas is for you:

• Santa Claus is Coming to Get Us (F22, Delusional disorders [includes paranoia])

Twelve Codes of Christmas: On the Fourth Day of Christmas...

As I type this, it's all about Vanessa Williams' Christmas album again. This time she's singing "Hark the Herald Angels Sing," which is another good rendition of a classic song. And of course, this leads me to our fourth carol and code:

Hark, the Herald Angels Sing About Me (F60.81, Narcissistic personality disorder)

Twelve Codes of Christmas: On the Third Day of the Coder's Christmas (F31.9)

Do you live next door to Clark Griswold? 

I love Christmas lights.  And I love Christmas decorations in general.  I do decorate my house to the extent where you can find something Christmasy in every room of the house.  Yes, every room.  I have a birthday around Christmas, so that combined with my love of holiday decor has led to my mom nicknaming me her Christmas kid.

But there comes a time when enough is enough.  Less is more. 

Last year I had a new neighbor and when they started hanging Christmas lights outside, I got a little excited.  I love it when all the neighbors get into the action and brighten up the neighborhood!  But there was a point when it reached Clark Griswold proportions and it just become too much.

So on the third day of the coder's Christmas, today'd carol choice is for all those with Clark Griswold tendencies:

• "Deck the Halls and Walls and House and Lawn and Streets and Stores and Office and Town and Cars and Buses and Trucks and Trees and Fire Hydrants and..." (F31.9, Bipolar disorder, unspecified)

Please note that this code includes bipolar disorder with a current manic episode, which would explain the incessant need to decorate it all.  And I suppose I could be accused of some of this, even though I've significantly reduced my decorating footprint over the last couple of years.  Nonetheless, you are sure to find a reindeer or snowflake in at least one of my bathrooms!

Twelve Codes of Christmas: On the Second Day of the Coder's Christmas... (F20.9)

I am still not 100% after almost 3 weeks of a really bad upper respiratory infection.  But last night I did hit an improvement milestone.  I was able to sing my favorite Christmas carols at top volume in the car on my way to dinner.  Yes, I am a car concert giver.  A legend in my own mind.

I have lots of favorites, but one last night was worth a repeat performance:  Do you Hear What I Hear by Vanessa Williams.  It's my favorite version of the song but I don't like the shortened version they play on the radio - the long version from the CD I've had for years is really the only way to listen to the song.

So this leads us to our carol and code for the second day of Christmas:

• Do You Hear What I Hear, the Voices, the Voices (F20.9, Schizophrenia, unspecified)

The mental disorders chapter of ICD-10-CM has undergone a lot of changes from its ICD-9-CM counterpart.  Schizophrenia is part of the psychoses section in ICD-9-CM, but ICD-10-CM eliminated the neurosis vs. psychosis terminology and moved to terminology more in line with DSM-IV.  The code above it now listed in the Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders section in ICD-10-CM.

Wait... do you hear it what I hear?  Thankfully it's not voices.  Bells!  An angel must have just gotten its wings.  Either that or one of the cats is scratching its ears and jingling the bells on its collar.

Twelve Codes of Christmas: On the First Day of the Coder's Christmas... (R41.3)

I remember the Christmas of 2006 vividly.  I can tell you which small town in the Eastern time zone I was in and the name of the hospital where I did my training the week before Christmas.  I can tell you how I suggested to the client weeks before that training a week before Christmas was probably not a good idea.  I can tell you how the people I was training plugged in a Christmas tree behind me and snacked on holiday pot luck fair while I was presenting.  And most of all, I can tell you that I was training ICD-9-CM, Chapter 5 on Mental Disorders.

Stellar memory you say?  That's absolutely amazing you say?  I certainly can't remember that many details about my other trainings.  It's what happened after that which makes the trip memorable.  Or maybe I should say during.  Christmas was on a Monday that year and on the Wednesday before - you know, when I was training - it started snowing in my home town of Denver.  A lot.  The airport was closed by Wednesday evening and it wasn't looking good for my flight home on Thursday. 

Sure enough, I was up bright and early Thursday morning and all flights in and out of Denver were canceled.  A massive blizzard had dumped nearly 2 feet of white stuff all over the city.  Once my Central-time zone based travel agent made it into the office, she was able to tell me I could fly home on the 26th.  Holiday travel combined with catch-up from Wednesday put me low on the priority list. 

To try to shorten this story up a bit, after crying to my travel agent and placing a very early morning and tearful call to my brother in Phoenix, I had a very expensive nonstop flight booked that would get me into Phoenix at midnight.  My wonderfully accommodating brother picked me up at the airport and his hospitality-driven wife had the guest room and Friday manis and pedis all set up. On Saturday, the three of us set out for Denver along with a small U-Haul trailer and two large dogs: one with a urinary tract infection (many potty stops) and the other with amazingly terrible gas.  Good times.

Oh right.  The point.

Recently, I was perusing the internet and came across a list of Christmas Carols for the Psychologically Challenged and remembered that fateful trip.  In order to infuse a little Christmas spirit into that mental health training, I had written these Christmas carols in the margins of my trainer's manual and we all had a good giggle any time one came up.

So in honor of that memorable Christmas - I've decided to do a special subseries on the code for the day.  Here is the first of my Twelve Codes of Christmas series:

• I Don't Remember if I'll Be Home for Christmas (R41.3, Other amnesia)

Tune in tomorrow for another installment!

Code for the Day: Awakening from a Tryptophan-Induced Coma (T50.3X2D)

I knew it had been awhile since I penned a blog post, but I didn't realize quite how long.  And how does one come back?  Which excuse should I use?  Well, now that we are two weeks post Thanksgiving, I choose tryptophan as my excuse - you know, that supposed chemical in turkey that makes us so sleepy after Thanksgiving dinner?  Did you know there is a code for overdosing on tryptophan?!

• T50.3X2D, Poisoning by electrolytic, caloric and water-balance agents, intentional self-harm, subsequent encounter

This code cracks me up.  I'm sure there is a real reason for this code to exist - I mean, besides blog fodder. But this one is just too good to be true.  I found this code by looking up tryptophan in the Table of Drugs and Chemicals and decided to use the column for intentional self-harm rather than accidental.  Because really, we do this turkey stuffing thing to ourselves.  And, of course, I chose the subsequent encounter because this isn't my first rodeo!

Just for good measure, let's also throw in this little gem for overeating:

• R63.2 Polyphagia

So now you're saying, well, Kristi, that was over two weeks ago, where the heck have you been?  This is where the coma part comes in and luckily, we have codes to capture the Glasgow coma scale too.  This is how I would rate my Thanksgiving experience:

• R40.2131, Coma scale, eyes open to sound, in the field [EMT or ambulance]
• R40.2221, Coma scale, best verbal response, incomprehensible words, in the field [EMT or ambulance]
• R40.2361, Coma scale, best motor response, obeys commands, in the field [EMT or ambulance]

Okay, not really.  In all honesty, since Thanksgiving, I've been trying to kick a nasty virus while continuing to meet work deadlines and other commitments.  The code for upper respiratory infection just isn't as much fun as the ones listed here. I hope you are having a healthier holiday season than me!