u/DumpsterPuff

I'm in a weird limbo where we don't actually know what my true diagnosis is. The MSLT showed no SOREM but I was on antidepressants during the test. We wouldn't be able to do a repeat without meds because I tried coming off of them and had a mental health crisis as a result. My doctor *thinks* I might actually have N1 because there's some evidence that I might have mild cataplexy, but it's hard to tell. Since we don't 100% know, for insurance purposes though he just made my diagnosis on paper as N1 so I could have access to medications, and it's been this way for almost a decade.

I'm super interested in trying an orexin agonist when they come out, but I don't know if they would *only* work for N1. I figured since they found out that Xywav works for IH, maybe these will work for it too? Definitely a long shot but at least wanted to ask if anyone has heard of either condition also being tested.

I live near the train tracks and they've been doing something on it all week. Right now there's this never ending WHIRRRRRRRRR that's driving me absolutely insane. I can even hear it through my noise canceling headphones with music playing. Just curious to know what they're doing.

So we have a major problem with our primary care providers where a lot of them avoid putting a diagnosis of overweight or obesity in the documentation. They'll put in just a BMI code or just say things like "desires weight loss" followed by BMI code, or "weight management" followed by BMI code. It's driving me absolutely nuts because it's literally not codable.

I typically send them a query saying that a BMI is a secondary diagnosis and that the primary condition being treated that the BMI measurement is related to needs to be indicated. Sometimes they get it, but I will also get messages back saying "BMI is the diagnosis" or "they're being seen because they want to lose weight." They don't seem to understand that there needs to be some sort of weight-related diagnosis to report BMI, or even that they can actually just code obesity.

When I look in the ICD-10 guidelines, it specifically states "BMI can only be coded if there is a separate, reportable diagnosis (such as obesity or anorexia) documented by the provider." If I send them this exact quote taken from the guidelines, including the part where it says "such as obesity or anorexia", does that come off as a leading query? I don't want to get in trouble but I just want to be clear as humanly possible to them so I can stop sending 8 billion messages about this every day.

I'm housesitting for my parents right now and they live in a very quiet neighborbood - unlike me where my apartment is next to a highway and a train comes through every hour or so. So I took advantage of the quiet and went to take a nap on the couch because I was exhausted.

Every 5 minutes, I kept hearing TAP... TAP TAP against the window that's right next to the couch. I tried to ignore it but every time as I was just about to fall asleep, TAP, TAP, TAP. After the 4th time I was getting pissed and looked out the window. There was this giant wasp that kept smashing itself against the windowpane. I was cranky and exhausted so I grabbed the first spray bottle I could find and ended up Windexing it to death.

I think committing war crimes against an insect has hit my number 1 pettiest things I've done because I just wanted to sleep.

Or more specifically, I hate AI charting when the providers won't review their notes and just click random buttons on the problem list that populates into an Epic charge session and the diagnosis is nowhere in the documentation. Or there's a bunch of AI-generated diagnoses that WERE captured in the note but weren't on the charge session. It's basically to a point where when I see on the top of the note "patient refuses recording" I breathe a sigh of relief. Our poor educators have been trying to inform the providers for months that they NEED to make sure everything is matching up but of course they won't listen. It's making HCC coding especially a massive nightmare.

Anyone else feeling my pain?

Are you guys also majorly affected by the days getting longer? For the past week it's taken me FOREVER to fall asleep and I wasn't sure why, until I realized that the sun has been out until almost 8:30pm. My bedtime is typically at 9. I'm dreading summer because I live in the pacific northwest and the sun doesn't set until almost 10pm here between June-August. Anyone else in the same shitty boat?

Hoping someone might be able to clarify this for me since the pharmacy is closed. So I've had to use the Xywav bridge program a couple of times in the past due to insurance issues. I just had to use it again last week and pretty sure I will have to use it again next week because my doctor's office PA team has been really dropping the ball this past month as far as communication and submitting the PA how the insurance wants it to be submitted as.

Anyways, so I saw there's a 120 day limit for the bridge program, but is that a lifetime 120 day limit? Or does it reset after a certain time frame (like a year or something)?