Solved by verified expert
Question
Answered step-by-step
Asked by CountHamsterMaster515
4.84) This is a 26 year old patient who had previous cesarean section for delivery for fetal distress. She had normal antepartum care and has had no complications. We are going to attempt a VBAC for this delivery. She is admitted in her 38th week in labor. The fetus is in cephalic position and no rotation is necessary. The labor continues to progress and 5 hours later she is taken to delivery. During the delivery she was fatigued, so low outlet forceps were required over a midline episiotomy which was subsequently repaired by an pictography. A single liveborn infant was delivered. What codes are reported?
ICD-10 CM code(s) with POA indicator and MS-DRG: ___________________________
ICD-10-PCS code(s):_____________________________
4.44) This 85-year-old patient, who is a resident at the skilled nursing facility, was admitted with a severe decubitus ulcer on the right buttock, stage 2, and a small chronic ulcer on the left heel limited to the skin area. Patient also has Alzheimer’s disease. The treatment was an excisional debridement of the skin of the heel and an open excisional debridement into the gluteus maximus muscle of the buttock. What is the code assignment?
ICD-10-CM Code(s) with POA Indicator and MS-DRG:
ICD-10-PCS Code(s): ____________________________________________
4.46) The patient had surgery two weeks ago for appendicitis. She is admitted now because of fever, pain, and redness at the operative site. There is evidence of cellulitis of the operative wound, and cultures confirm Staphylococcus aureus as the cause. She received IV antibiotics. She also has type 2 diabetes mellitus and is on oral antidiabetic medication. What codes are assigned? ICD-10 CODES:
4.26) From the health record of a patient requiring thyroid surgery:
History: Patient is a 50-year-old female who noted a swelling in the neck. Outpatient workup was done. Thyroid scan and thyroid sonogram revealed moderate enlargement of the left lobe of the thyroid gland measuring 1.1 x 2.2 cm, a solid nodule at the anterior aspect of the mid of the left lobe of thyroid measuring approximately 1 × 1.9 cm, a small cyst in the middle of the left lobe of the thyroid measuring 2.4 cm, normal right lobe of the thyroid, and a small cyst in the mid of the right lobe measuring 2.3 mm. Thyroid scan showed hot nodule, which is usually negative for malignancy. The fine- needle aspiration was strongly suspicious for papillary carcinoma.
Impression: Papillary carcinoma of the thyroid
Report of Operation:
Preoperative Diagnosis: Steroid nodule left lobe, rule out papillary carcinoma
Postoperative Diagnosis: Papillary carcinoma of thyroid
Procedure: Left thyroid lobectomy with isthmusectomy and frozen section. Subsequently, patient underwent total thyroid right lobectomy.
Anesthesia: General endotracheal
Estimated Blood Loss: 50 cc. Replacement: IV fluids, sponge count, needle count times two correct
Technique: After patient was well anesthetized with general endotracheal anesthesia, a sand bag was placed underneath the shoulder blades. The neck was extended and stabilized and placed on a foam head pillow. Entire neck and anterior chest was prepped and draped in the usual manner. The skin incision site was marked with 2-0 VICRYL suture with pressure. Preempt analgesia was obtained with infiltration of 25 percent Marcaine. Transverse skin incision was made in the anterior part of the neck, which was deepened through the subcutaneous tissue and the platysma. Upper and lower flaps were raised, upper flap up to the thyroid cartilage, lower flap up to the sternal notch. Hemostasis obtained with cautery as well as 3-0 VICRYL sutures. Midline fascia was incised. Strap muscles on the left side were separated from the underlying thyroid gland. Strap muscles were retracted laterally with a Green retractor. Middle thyroid veins were identified, divided between the clamps, ligated with 3-0 VICRYL suture. Patient was noted to have palpable thyroid nodule on the left lower part of the thyroid gland. Superior thyroid vessels were identified. External of the superior laryngeal nerve was identified and protected. Superior thyroid vessels were divided close to the thyroid clamp between the Mixter clamp and ligated with 2-0 VICRYL suture. Recurrent laryngeal nerve was identified and protected throughout the procedure. Superior and Inferior parathyroids were identified, protected with their vasculature. Inferior thyroid vessels were divided close to the thyroid capsule after its branching to preserve the blood supply to the parathyroid gland. Isthmus was divided between the clamps, and the entire thyroid lobe was removed and sent for frozen section, which was reported to be a papillary carcinoma. After the pathology report, the decision was made to proceed with the total thyroidectomy, which was carried out in the following manner: Strap muscles on the right side were separated from the right thyroid gland. Middle thyroid vessels were divided between the clamps, ligated with 3-0 VICRYL suture. Superior and inferior thyroid poles were identified. Superior thyroid vessels were divided close to the upper pole. During the procedure, the external branch of the superior laryngeal nerve was identified and protected. The divided vessels were ligated with 2-0 VICRYL suture. Recurrent laryngeal nerve was identified and protected. Inferior and superior parathyroid glands were identified and protected with vasculature. Inferior thyroid vessel branches were divided between the clamps; thereby the blood supply to the parathyroid glands was preserved. Care was taken to protect the recurrent laryngeal nerve throughout the procedure. The right lobe of the thyroid was completely removed after satisfactory hemostasis. We also excised a suspicious lymph node from this side for biopsy. No drains were placed. The strap muscles were approximated with interrupted 3-0 VICRYL suture. Platysma and subcutaneous tissue was approximated with interrupted 4-0 VICRYL suture. Skin approximated with subcuticular 4-0 Dexon. Sterile dressings were applied. At the end of the procedure the vocal cords were inspected. They were moving equally well. The patient tolerated the entire procedure well and was discharged in stable condition to the recovery room.
Discharge Information: Patient discharged after two days, with no complications.
Diagnosis: Papillary carcinoma of the thyroid, left and right lobes, with follicular pattern. Papillary carcinoma positive in one cervical lymph node. Will follow up with me in the office.
What are the correct codes in this case?
ICD-10-CM Code(s) with POA Indicator and MS-DRG:
ICD-10-PCS Code(s):
4.22) The patient was admitted because of severe abdominal pain. There has been a history of abdominal pain and some bleeding, but never this severe. Because of the symptoms, the patient underwent an emergency laparotomy to repair the perforation in the antrum of the stomach by suturing. The physician states: acute peptic ulcer with perforation and bleeding.
4.20) The patient is a 44-year-old male who started having abdominal pain the day before yesterday. Subsequently he had diarrhea. He had 4 episodes of diarrhea last night and then 4 episodes in the morning. The stools have turned to fairly frank blood. Also the abdominal pain got worse, and he said he felt dizzy when he stood up. Patient admitted for treatment of dehydration. Patient has frank blood coming out from his bowels. Stool culture and sensitivity revealed Salmonella. Physician documented that the abdominal pain, diarrhea, and bleeding were due to Salmonella gastroenteritis. Patient put on Levaquin IV and also rehydrated. Patient responded well and was discharged. What codes are assigned?
aA02.0, E86.0
bK52.89, A02.0, E86.0
cA02.0, K92.2, E86.0, R19.7
dE86.0, A02.0
4.12) A 75-year-old male patient was admitted for an acute exacerbation of chronic systolic congestive heart failure and severe mitral regurgitation and aortic stenosis. What would be the correct code assignment for this case?
I50.23, I08.0
I50.23, I50.9, I08.0
I50.9, I05.1, I35.0
I01.8, I08.0
4.2) An 8-year-old male hemophiliac is admitted with acute blood loss anemia following uncontrolled bleeding. He was given 4 units of packed red blood cells via the peripheral vein. While in the hospital he also received his regular preventive infusion of clotting factors. Which of the following ICD-10 CM answers would be correct?
Question 9 options:
aD66
bD62, D66
cD66, D62
d D62
4.98) From the health record of a patient who is status post joint replacement:
Discharge Summary The patient is an active 61-year-old male, who underwent right total hip arthroplasty approximately three years ago. The patient is very active and walks several miles every day and enjoys playing golf. He has recently experienced several instances of failure of the right hip prosthesis. This is well documented in several ED visits for dislocation of the prosthetic hip. The patient was now admitted for scheduled replacement of the right hip arthroplasty. The patient was taken to surgery, where the old prosthesis was found to be eroded and bent, causing the repeated dislocations. The entire prosthesis (both acetabular and femoral components) was removed and replaced with a titanium/ polyethylene prosthesis using cement without incident. The patient was begun on physical therapy for prosthetic gait training while in the hospital to help regain mobility. The patient was discharged on the fifth day postop to continue the physical therapy as an outpatient. ICD-10-CM Code(s) with POA Indicator and MS-DRG:
ICD-10-PCS Code(s):
SCIENCE
HEALTH SCIENCE
NURSING
BIOLOGY MISC
******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."
