A 62-year old male who was diagnosed with pancreatic cancer two weeks ago, was admitted to the hospital with malaise, fever, and an elevated WBC of 15.21 k/uL. The patient was diagnosed with sepsis. Blood cultures were positive for carbapenem-resistant Enterobacteriaceae (CRE). Infectious Diseases was consulted. A review of the patient’s history revealed that the patient had undergone an ERCP with biopsy of the pancreas approximately two weeks ago at which time a diagnosis of cancer of the head of the pancreas was made. It was eventually determined that the patient had been contaminated with the CRE organism from the duodenoscope used during the ERCP. The patient was discharged to an extended care facility with a PICC line for ongoing IV antibiotic therapy. Assign diagnosis codes for this inpatient encounter and sequence appropriately. Continue reading
It’s that time of year again. For people not working in the healthcare industry, it’s time for flowers to start blooming, windows to be opened to fresh air, swimsuit shopping and, even though we had a short-lived blizzard in Colorado yesterday, I’m ready for spring! Let the spring cleaning begin. However, there is the painful memory of last year, when ICD-10 was delayed “at least until October 1, 2015” via the SGR repeal bill, also known as the doc fix bill. I remember exactly where I was when I heard the news. Continue reading
Donna: Hello from Down Under where they have been using ICD-10 since 1999!
Sue: Hi! How has your work and your visit been going? Have you learned any ICD-10 tips worth sharing? Continue reading
An 11-year old boy with severe autism presents to the Emergency Department with a fall from a 4-5 foot round hay bale. He landed backwards on his left arm and chest two hours ago at his family’s farm. His father was present at the time of the fall and states that he did not lose consciousness, but might have “gotten the wind knocked out of him.” He got up afterwards and was ambulatory. His parents brought him in because he was not moving his left arm and was supporting it with his right arm. On examination, the left arm is minimally swollen and there is moderate pain. Pain is relieved with positioning and immobilization of the arm. The exam was difficult due to pain and the patient’s autism. Intranasal fentanyl was administered so proper assessment could be completed. Continue reading
It’s our 500th blog post! Our first blogs focused on ICD-10, so it’s fitting that today’s post is written by ICD-10 blogger Rhonda Butler. Read Rhonda’s very first blog post here.
The GEMs are nothing more than ICD-10 training wheels. You can use them to get the hang of ICD-10, but then you should just use ICD-10 directly—stop leaning on the extra wheels and just ride the bike.
Remember that first moment? Pedaling faster to get off the training wheels is intolerably scary for about two seconds, and then suddenly it’s like flying and you don’t even remember being afraid. As an industry we have had the training wheels on long enough. We should be weaning ourselves from the GEMs. Continue reading
Posted in ICD-10
Tagged CMS, GEMs, ICD-10
Donna: Sue, did you listen to the U.S. House Energy & Commerce Subcommittee hearing on health industry readiness for ICD-10 last week?
Sue: I wasn’t able to tune in as I was at a customer site that day, but I read all of the presenter remarks and watched video of the questions asked by the subcommittee and the responses from the panel of witnesses. It’s all posted on the Coalition for ICD-10 website. How about you?
Donna: I had the hearing on in the background while I was working, but I didn’t get to listen to the entire proceedings because I was on conference calls . . . you know how it goes. So what did you think? Continue reading
A subway train car filled with thick black smoke due to an electrical malfunction. One woman on board had difficulty breathing and collapsed to the floor of the train, unconscious. Fellow passengers began performing CPR in an effort to help the woman. Emergency workers arrived and transported the woman to the Emergency Room of a nearby hospital. Resuscitative efforts were continued to no avail and the woman expired. The Emergency Department physician recorded the following diagnoses: acute respiratory failure due to smoke inhalation.
Assign diagnosis codes for this outpatient encounter. Continue reading
Yes, there are ICD-10 codes for exceedingly rare ways to die, and yes, they are easy to parody. This does not matter at all, since not many people are admitted to the hospital for a prolonged stay in a weightless environment.
What does matter is that preventable errors in hospital care are the third leading cause of death, after cancer and heart disease. Updated estimates in a 2013 study in the Journal of Patient Safety say that between 210,000 and 440,000 people die in US hospitals every year because some preventable harm was done to them. Continue reading
Sue: Happy New Year, Donna! Did you enjoy the holidays?
Donna: The holidays were wonderful, and you know I always feel reenergized in the new year!
Sue: Me, too! Instead of making New Year’s resolutions though, I focus on cleaning, straightening and getting organized.
Donna: Speaking of getting organized, I started making a list of what needs to be accomplished before ICD-10 goes live in October. Continue reading
A 72 –year old male was admitted to the hospital with a chief complaint of a fever with a temperature of 101° F and feeling ill with worsening chills, cough, nasal congestion and body aches that began two days prior to admission. A chest x-ray revealed bilateral infiltrates in both lower lobes of the lungs. A viral culture was positive for AH3N2 influenza. The patient received antiviral medication and supportive care. The patient recovered enough to be discharged three days later with a diagnosis of pneumonia due to AH3N2 influenza.
Assign ICD-10 diagnosis codes for the inpatient hospitalization. Continue reading