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Top 10 Causes of DKA Hospitalization (ICD-10 Codes)

Most internists are taught the three most common causes of hospitalization for diabetic ketoacidosis (DKA) are infection, infection, infection.  In clinical reality, the three most likely causes of hospitalization for DKA are didn't take insulin, didn't take insulin and didn't take insulin.  With ICD-9, E15.1 could be used to code DKA Hospitalization Due to Noncompliance.  With ICD-10 coding rules, didn't take insulin is not specific enough to code the cause of DKA hospitalization.  The new ICD-10 codes provide a much more detailed look at the causes of DKA leading to hospitalization and will hopefully allow healthcare agencies an enormous amount of your personal data to improve public health.


TOP 10 CAUSES OF DKA HOSPITALIZATION (ICD-10 CODES)


1)  I forgot to take my insulin because I was Playing Pokemon GO. (E15.1)

2)  I forgot to take my insulin because I was twerking  and puking all night. (E15.2)

3)  I didn't to take my insulin because I was was nauseated and had abdominal pain and I was light headed and I wasn't eating and I didn't know what my sugar was.  (E15.3)

4)  I didn't take my insulin because I didn't f**king feel like it. (E15.4)

5)  I ran out of my insulin and couldn't even afford to buy a pack of cigarettes and I didn't have a friend to bum a bottle of insulin off of. (E15.5)

6)  I told everyone at the hospital I took my insulin just like I was supposed to but I actually haven't taken it for a week because I didn't f**king feel like it. (E15.4.6)

7)  Whether I took my insulin or not is none of your business and can I have some Dilaudid and a bag of Cheetos for my abdominal pain? (E15.7)

8)  I didn't take my insulin because the doctor who told me seven years ago I had diabetes didn't know what they were talking about. (E15.8)

9)  I didn't take my insulin because this sh*tty hospital wouldn't give me free insulin to take home when I was hospitalized last week. (E15.9)

10)  DKA hospitalization unknown because the childlike adolescent in their upper 20's who lives with their enabling parents refused to talk, gave nasty faces and slept with their boyfriend/girlfriend every night and then left AMA after eating a hearty breakfast.  (E15.10)

With ICD-10 exposing the top 10 causes of DKA hospitalization, make sure to provide insight for other readers with your experiences as well.  In the interest of public safety, please leave your experience with the causes of DKA hospitalization in the comments below so other healthcare professionals can gain a greater understanding of what to be on the lookout for when frequent flyer DKA patients come to the ER for hospitalization.

"So you have another DKA hospitalization this month.  Tell me again how you took all your insulin and have no idea why this happened, again."

So you have another DKA hospitalization this month.  Tell me again how you took all your insulin and have no idea why this happened, again.



18 Awesome Pokemon GO Medical Memes for Doctors and Nurses and Patients!

Pokemon GO, the augmented reality smart phone game, has taken the world by storm.  Millions of addicted players are roaming the streets, day and night, hunting pikachus with gross disregard for everyone around them.  And what better way to discuss how Pokemon GO has affected doctors, nurses and patients alike than 18 perfectly described medical memes explaining the many ways life is now different in a post Pokemon world.  Please enjoy these 18 original Happy Hospitalist Pokemon medical memes and feel free to add your own in the comments below.  Now stop reading and GO Pokemoning!


"Waiting for call light to get answered while everyone plays Pokemon GO."

WAITING FOR CALL LIGHT TO GET ANSWERED WHILE EVERYONE PLAYS POKEMON GO.


"The number of ER patients playing Pokemon GO is too damn high!"

THE NUMBER OF ER PATIENTS PLAYING POKEMON GO IS TOO DAMN HIGH.


"You said you weren't playing Pokemon GO when you called in sick three days this week.  The lie detector determined that was a lie."

YOU SAID YOU WEREN'T PLAYING POKEMON GO WHEN YOU CALLED IN SICK THREE DAYS THIS WEEK.  THE LIE DETECTOR DETERMINED THAT WAS A LIE.


"You get discharged!  And you get discharged!  Everyone gets discharged! (when playing Pokemon Go))"

YOU GET DISCHARGED AND YOU GET DISCHARGE.  EVERYONE GETS DISCHARGED WHEN PLAYING POKEMON GO


"Am I the only one around here not playing Pokemon GO?"

AM I THE ONLY ONE AROUND HERE NOT PLAYING POKEMON GO


"You brought your kid to the ER because he wouldn't stop playing Pokemon GO?  WTF!"

YOU BROUGHT YOUR KID TO THE ER BECAUSE HE WOULDN'T STOP PLAYING POKEMON GO.  WTF.


"That face you make when ER patients check in playing Pokemon GO in triage."

THAT FACE YOU MAKE WHEN ER PATIENTS CHECK IN PLAYING POKEMON GO IN TRIAGE.


"You want Dilaudid for 12/10 pain, but you're playing Pokemon GO in my ER? No...No! No! No!"

YOU WANT DILAUDID FOR 12/10 PAIN, BUT YOU'RE PLAYING POKEMON GO IN MY ER.  NO NO NO NO


"What if I told you playing Pokemon GO in the ER will automatically get you Tylenol for pain."

WHAT IF I TOLD YOU PLAYING POKEMON GO IN THE ER WILL AUTOMATICALLY GET YOU TYLENOL FOR PAIN.


"You came to the hospital for sepsis, but you want to come and go as you please to catch pikachus?"

YOU CAME TO THE HOSPITAL FOR SEPSIS BUT YOU WANT TO COME AND GO AS YOU PLEASE TO CATCH PIKACHUS?


"Came to the ER looking for Dilaudid but left AMA to play Pokemon GO instead."

CAME TO THE ER LOOKING FOR DILAUDID BUT LEFT AMA TO PLAY POKEMON GO INSTEAD


"If you could stop playing Pokemon GO in the ER that would be great."

IF YOU COUD STOP PLAYING POKEMON GO IN THE ER THAT WOULD BE GREAT.


"I see you caught 77 pikachus while your patient called 911 for help, but that's none of my business."

I SEE YOU CUAGHT 77 PIKACHUS WHEIL YOUR PATIENT CALLED 911 FOR HELP, BUT THAT'S NONE OF MY BUSINESS.


"Tell me again how you came to the ER with the worst headache ever, while playing Pokemon in the waiting room."

TELL ME AGAIN HOW YOU CAME TO THE ER WITH THE WORST HEADACHE EVER WHILE PLYING POKEMON IN THE WAITING ROOM.


"Prepare yourself.  Your doctors and nurses are too busy playing Pokemon GO."

PREPARE YOURSELF.  YOUR DOCTORS AND NURSES ARE TOO BUSY PLAYING POKEMON GO.


"One does not simply claim 12/10 pain while in the ER playing Pokemon GO."

ONE DOES NOT SIMPLY CLAIM 12/10 PAIN WHILE IN THE ER PLAYING POKEMON GO.


"There's a pikachu in room 12 I need to catch.  But you have 6 patients to finish charting on."

THERE'S A PIKACHU IN ROOM 12 I NEED TO CATCH.  BUT YOU HAVE 6 PATIENTS TO FINISH CHARTING ON.


"I don't always play Pokemon GO at the hospital.  But when I do, the patients with 12/10 pain are usually joining in."

I DON'T ALWAYS PLAY POKEMON GO AT THE HOSPITAL BUT WHEN I DO, THE PATIENTS WITH 12/10 PAIN ARE USUALLY JOINING IN.