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Medical Codes review and surgical update, orders updated

Posted Jun 16 2009 6:51pm
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The medical code on my website was on CODE REDfor a long time without me realizing it was incorrect thus I am reviewing our coding procedures. The code is currently a CODE REDdue to the emergency priority General Surgical visit today.

CODE GREEN - This is probably a code we will NEVER see again. Code green used to be used when all was totally normal and absolutely no monitoring or at home procedures were needed. Since I am almost ALWAYS under some sort of monitoring and procedure this code is effectively considered retired and not our “Normal” code

CODE YELLOW- This is our “Normal” medical code. You WANT to see code yellow updates on the blog and site. Code yellow means standard monitoring and procedure is being followed and NO TYPE OF EMERGENCY DOCTORS VISIT OR SURGERY IS SCHEDULED. ROUTINE DOCTOR VISITS MAY BE ASSIGNED A CODE RED TAG IF THEIR PRIORITY WARRANTS.

CODE RED- code red is a very difficult to use code. I mainly change to code red when a HIGH PRIORITYDOCTORS VISIT IS  MADE and or when a surgery is SCHEDULED. CODE RED IS NOT FOR LIFE THREATENING EMERGENCIES AND OR EMERGENCIES OF NATURE WITH LESS THAN 24 HOURS TO SURGERY OR VISIT. i.e The Baclofen Pump story and its second surgery. In the case of The Baclofen Pump story that occurred within 24-48 hours and would be a CODE RED, the second surgery should have been but was not coded as a CODE BLUE.

CODE BLUE- code blue is also a difficult code to use. it is EXCLUSIVELY reserved for EXTREMELY HIGH PRIORITY surgeries and or E.R visits or other things that require immediate attention (under 24 hours) a previous example of a code blue situation was the Second Emergency Baclofen Pump Surgery

Today we are going in to my general surgeons office to get my G-Tube inspected and replaced with a new longer tube, after last night discovering the current tube in me is a 2.7 cm length and my current prescribed tubes are 3.0 cm tubes. I have NOT had pain issues with this tube the whole time it was in so the I do NOT think is what is causing the unusual pressure sensitive pain that is relieved by wearing a belt tightly over the G-Tube. My opinion is either the tube is DISLOCATED or there is a ULCER. Both of which in certain cases have pressure sensitivity by using pressure to Desensitize the stomach and Sensitize it to the external non painful stimulus. There are three ways that this visit could head.

A. NEW or OLD Tube is found to be dislocated or ulcerated to warrant emergency, blog status changes to code blue, i get admitted to the hospital and endoscopy to be done ASAP (within 24 hours) If the old tube does not come out easily or comes out very painfully or blood is present the code blue plan will likely occur

B. OLD tube comes out normally, NEW tube goes in although seems painful or otherwise abnormal, a VFRS (Video Fluroscopic Radiographic Study) will be performed, I will lay on my side on the X-Ray table and a special video X-Ray system will be booted, constantly bombarding me with x-rays and a photodetector will detect what passes through (like a normal X-Ray) at approximately 15 frames per second, at this point certain movements of the tube will be done and infusion of barium will follow along with more tube movement to see tissue and tube reaction. if new tube shows signs of ulcer or persistent displacement plan A will activate and a code blue will occur

C. OLD tube comes out normally NEW tube goes in normally or with minimal pain but still shows question for ulcer. an endoscopy will be scheduled ASAP within the next 2 weeks. blog will remain code red.

Medical orders updated as follows

  • Pulse Oximeter (ordered by pulmonary) <INACTIVE> [WAIT FOR BETTER INSURANCE]
  • ETCO2 monitor (ordered by pulmonary) <INACTIVE>[WAIT FOR BETTER INSURANCE]
  • Endoscopy (2 year follow up & suspected internal pressure ulcer from G-Tube + H. Pylori follow up) (IP) <WAIT SCHEDULING>
  • Muscle Biopsy – See if there is a muscular dystrophy or other disease directly affecting the muscle such as progressive rhabdmyolysis. (Live – To be scheduled) (OP / IP at doctors discretion)<WAIT SCHEDULING>
  • Toxicology panels (drug & standard) – See if disease caused by toxic mutagenic agent (Live – To be scheduled) (OP) <INACTIVE>[WAIT FOR BETTER INSURANCE]
  • Urodynamics study (under anesthesia or neuromuscular blockade) (repeat due to question of suprapubic catheter) (IP) <WAIT SCHEDULING>
  • Echocardiogram (repeat due to 1 year passing since last ECHO) (IP)<WAIT SCHEDULING>
  • CT head & spine w/o contrast and with contrast (repeat due to 1 year passing since last CT series) (IP) <WAIT SCHEDULING>>

are also waiting on a few other things to be ordered after the completion of these, the next order batch is. All of the below are considered dead until converted to live orders.

  • Deep Brain Stimulator insertion surgery talk (new surgery in talks) (IP, Duh!) <INACTIVE>
  • Pulmonary Functions Test + Waking ABG draw (resp problems, PFT is a default test every 3 months, 4 months passed. waking ABG based on research) (OP / IP PFTs to be OP ABGs probably IP) <INACTIVE>
  • Spinal plain X-Ray series – June(6 months will have passed, usually done twice yearly) (OP) <INACTIVE>

Excuse the absurd length of this post! Stay tuned for updates!

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