Coding Practice - Infectious, Blood, Circulatory, Respiratory, Endocrine, Digestive Diseases

1. Unit 3 Overview • Reading, Understanding ICD-9-CM Coding Chapters 6, 9, and 12 • Seminar, Attend Seminar or complete option 2, 20 points • Discussion, HIPAA, 25 points • Exercises, Challenge exercises derived from your textbook, 20 points • Quiz, Mental disorders, signs and symptoms with ill-defined conditions, infectious and parasitic diseases including HIV/AIDS, blood and blood-formation diseases including anemia, coronary artery disease, hypertension, and cerebrovascular accidents. 60 points

2. Coding Practice-Infectious Diseases • Inpatient admission: This HIV-positive patient was admitted with skin lesions on the chest and back. Biopsies were taken, and the pathologic diagnosis was Kaposi’s sarcoma. Leukoplakia of the lips and splenomegaly were also noted on physical examination. • Discharge diagnoses: (1) HIV infection, (2) Kaposi’s sarcoma, back and chest, (3) leukoplakia, (4) splenomegaly.

3. Coding Practice-Blood • Inpatient admission: The patient had a congenital aplastic anemia that had been responding well to treatment. She was admitted for observation following a full-mouth extraction for multiple dental caries and pyorrhea in outpatient surgery. She had only minimal bleeding following surgery. However, it was believed to be necessary to admit her for monitoring. She was discharged the next day with her blood counts remaining at acceptable levels. • Discharge diagnoses: (1) Aplastic anemia, (2) dental caries, (3) pyorrhea.

4. Coding Practice-Circulatory • Inpatient admission: The patient was admitted with recurrent unstable angina that could not be controlled with sublingual nitroglycerin. On left cardiac catheterization with coronary arteriography, a narrowing in the left anterior descending coronary artery and a stenotic area in an intermediate branch were identified. A successful percutaneous transluminal coronary angioplasty (PTCA) of both vessels was carried out. • Discharge diagnosis: Unstable angina secondary to coronary arteriosclercsis, (2) chronic total occlusion of coronary artery

5. Unit 4 Overview • Understanding ICD-9-CM Coding, Chapter 8, Chapter 13, Chapter 14 • Discussion Board, Coding Ethics and Fines, 25 points • Exercises, Challenge exercises derived from your textbook, 40 points • Seminar, Seminar or complete option 2, 20 points

6. Coding Practice-Respiratory • Inpatient admission: The patient, a 51-year-old woman with acute respiratory failure secondary to an acute exacerbation of chronic asthmatic bronchitis, was brought to the emergency department by emergency medical services. In the emergency department, she was intubated and placed on mechanical ventilation. On admission, it soon became apparent that she had suffered severe, irreversible hypoxic encephalopathy. On day 5, she was weaned from the ventilator and extubated; however, significant neurological function was never regained. In accordance with her advance directive, tube feedings were discontinued. She became febrile and dyspneic. Antibiotics were started to provide comfort and relief of her pneumonia. She expired on day 13. • Discharge diagnoses: (1) Acute respiratory failure secondary to chronic obstructive bronchitis, (2) pneumonia, (3) encephalopathy.

7. Coding Practice-Endocrine • Inpatient admission: The patient was admitted for additional evaluation of her adrenal malfunction. She had a 4-year history of hypertension and hypokalemia with evidence of primary aldosteronism. A CT scan of the abdomen also suggested a left adrenal mass. She was discharged and was to return for a left adrenalectomy the following week. • Discharge diagnoses: (1) Probable adrenal mass, left, (2) hypertension and hypokalemia probably due to primary aldosteronism.

8. Coding Practice-Digestive • Inpatient admission: The patient, who underwent a gastric bypass 3 weeks earlier, had nausea and vomiting for 1 week. She was admitted with continuous vomiting and severe dehydration. Radiologic and laboratory studies provided no indication of problems with the previous surgery or other abnormalities. Rehydration was accomplished. On close observation, it appeared that she was eating too fast and too much. • Discharge diagnoses: (1) Exogenous morbid obesity with gastric bypass, (2) dehydration due to continuous vomiting

9. The End Questions