he following MS-DRG assignments for accuracy. Defend your answers and provide Ev
ID: 245256 • Letter: H
Question
he following MS-DRG assignments for accuracy. Defend your answers and provide Evaluate t corrections if necessary 1. A 12-year-old, intellectually disabled male (IQ-19) was admitted from home with high fever (105.2) and chills. He had been experiencing a hacking cough for tw days prior to admission and was very lethargic. Lab work, sputum culture, rapid flu test, and chest x-ray were performed. Flu test was negative and chest x-ray indicated acute bronchitis. Due to the patient's severely weakened condition and low 02 levels he was admitted. After two days in the hospital where he received IV antibiotics and respiratory treatments for the acute bronchitis, he was much improved and ready for discharge back to his home MS-DRG assigned 203 Admit diagnosis R50.9 Principal diagnosis 120.9 2. A 68-year-old female was admitted from skilled nursing with complaints of right flank pain and fever. This developed one day after her last dialysis treatment for CRF. Lab work was drawn, urinalysis performed, and a KUB showed evidence of a renal calculus. The urinalysis indicated a UTI, and the patient was admitted for definitive treatment of the streptococcal B UTI and renal calculus. IV antibiotics were administered and increased fluids flushed the stone. By the third day, the UII seemed to be clearing so the patient was discharged back to skilled care. Her hypertension was controlled during her admission with Atenolol MS-DRG assigned 694 Admit diagnosis Principal diagnosis Secondary diagnosis R10.9 N20.0 N39.0 B95.1 I10 N18.9 3. A 69-year-old male was admitted after arrival in the ER with extreme shortness of breath. He was found to be experiencing an acute exacerbation of his COPD and therefore admitted for treatment. On the second day of his admission, he began complaining of right knee pain. Examination indicated a pyogenic arthritis and an aspiration of the joint was done and appropriate antibiotics started. Two days later both the patient's respiratory and knee conditions were much improved and the patient was discharged homeExplanation / Answer
1. The assigned codes and diagnosis is correct. The admit diagnosis is fever and code is R50.9 and the principal diagnosis is acute bronchitis and the code is J20.9
2. In this case, all the assigned codes are correct except diagnosis of fever with code R50.9 can be included. The admit diagnosis is R10.9 abdominal pain, principal diagnosis N20.0 renal calculus, secondary diagnosis N39.0 urinary tract infection, B95.1 streptococcal infection, I10 hypertension and N18.9 is CRF.
3. In this case the assigned codes are correct except diagnosis of pyogenic arthritis M00.9. The admit diagnosis is R06.02 shortness of breath, principal diagnosis is J44.1 COPD with exacerbation, secondary diagnosis is M25.561 pain in right knee, procedure performed is 0S9C3ZZ drainage of right knee joint.
4. In this case the assigned codes are correct except the procedure of left heart catheterization was done and the code Y84.0 should be added. The admit diagnosis is I25.10 atherosclerotic heart disease, the secondary diagnosis is E11.9 type 2 diabetes mellitus, I10 hypertension and the procedures performed are 021309W bypass coronary artery, 06BP3ZZ excision of right saphenous vein.
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