What a Relief!

I have invested a lot of money and time into this career shift. A LOT OF TIME. And I have almost never been more unsure of something in my whole life. I have never been outside of the restaurant/bar business. Well, alright, in the summer of 1984 my first “job” was landscape work on some neighbor’s yard in Tucson, AZ for what was probably peanuts. It was summer in Arizona, it was brutal.

And I had a two month hardware store stint in the winter in Green Bay. The only memory of which was being blown off the road by a blizzard and stranded with a news crew filming my car with its Arizona license plates (I had just moved there). Tip: it is apparently frowned upon to get out of said car, light up a cigarette and start walking in whatever direction you think might be best. Luckily the redneck in the giant pick-up upbraided me for my stupidity but eased up when I told him I had just moved to Green Bay from Arizona. He was cool, we stopped for a few a lot of beers at a bar. All perfectly legal, it was Wisconsin and it was beer, that’s not really drinking and driving.

The other memory of that job was the lumber always showing up when the temperature dipped below zero.

So my memories of work outside the business are quite unpleasant. Except for the day I never made it.

So, last January 2015, I put aside my writing, curtailed my fiction reading (you have no idea how hard those two things were) and entered school (online school, but that doesn’t make it easier (I know, my first thought was it would be easier too) it makes it harder – think of discipline… ah, there you go) for medical coding. After working on my feet since 1984, I wanted to be off my them as much as possible. And the thought of me heading into my 50’s in basically the same line of work 30 plus years later, and helping 21 year old girls celebrate their birthdays, wasn’t appealing to me. Neither was my old ass breaking up fights.

I chose medical coding because you have to reference a lot of stuff and I love doing stuff like that. Go ahead, somebody give me a laundry list of stuff to look up and research, and I’ll go fetch it for you just like a puppy dog. It is the kind of meticulous work that has you buried for eight hours. But this was 14 months of memorizing terms and guidelines and acronyms, abbreviations, regulations, government compliance, medical terminology and jargon.

Last weekend I finally broke through to the part with the actual coding. Preliminaries, sure. A few more guidelines, oh yes. But tonight I was finally able to do an exercise that had me flipping my code book (one of them anyway, the 1150 page ICD-10-CM (that’s the International Classification of Disease 10th Edition Clinical Modification).

Without going into all the scuttlebutt about what it takes to get a code, let it suffice to say that it is absolutely not as simple as looking up “flu” in the book and writing down a code. Where would you start – the Alphabetic Index, the Tabular List? Does it matter? What type of flu?

So my first string of codes (I found it challenging and fun) were probably, or will be in retrospect, sort of easy.

  1. Chronic hypertrophy of tonsils and adenoids
  2. Fibrocystic disease of breast (female)
  3. Acute suppurative mastoiditis with subperiosteal abcess
  4. Recurrent direct left inguinal hernia with gangrene
  5. Acute upper respiratory infection with influenza

I was pretty sure I had at least the first item, but I could just as well had all of them wrong.

But I got them all right. Some of them can be downright tricky. #2, for instance has (female) as one of the descriptors. You have to be careful. Is that necessary to the correct diagnostic selection? You are not selecting the diagnosis literally, the physician does that, but you do have to take his information and choose the proper code that best fits the information.

Anyway, it was the first time I felt like this was something I could actually be doing. And you could just stuff me in a corner all day long and have me plow through stuff like this.




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