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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

Palliative Care Coding-Symptoms or conditions?

Hi Everyone,

I need input on a specific topic regarding Palliative care coding. I’ve read many articles online and read through forums to try to obtain these answers and I feel that they are all over the place. When coding for Palliative care, I was told that symptoms are coded over definitive conditions, and I’ve also been told to code definitive conditions as well if they are appropriate. I find it hard to distinguish when to do this. Does anyone have a straight answer for me, I want to relay the message to my Palliative providers correctly. For example: provider is documenting that the patient has dyspnea due to COPD exacerbation. Do I code the dyspnea or the COPD exacerbation? I want to code the COPD because it is confirmed, however the provider is concerned with the COPD being used for the same day by another provider. Any input on this topic would be very helpful!

Thank you in advance.

Medical Billing and Coding Forum

Coding Comorbid Conditions

I work in physician coding for specialty practices (Neurology, Rheumatology, etc.). I’ve only been coding for about 6 months now and a few days ago we were discussing comorbid conditions and when to code/not code them. Does anyone have any insight for me or documented instructions when to code comorbid conditions in ICD-10 coding? I’m specifically looking for whether or not the physician has to actually addresss the conditions or if they can be taken from the HPI or past medical history, etc., and coded after the primary/secondary diagnoses? Thanks for your help!

Medical Billing and Coding Forum

Chief Complaint/Status of Chronic Conditions

Does the chief complaint need to be separate from the HPI? There has been information out there that says that the chief complaint can listed under its own header or as the first sentence of the HPI (as long as it is clear). At my facility, many providers are split when doing this and I am trying to find out which is the correct way because it would alleviate a lot of extra work on both ends.

IF the chief complaint can be the first sentence of the HPI, would this suffice for chief complaint and status of one chronic condition? Example: Patient presents for follow up on hypertension and states he is doing well and offers no complaints.

Please let me know your input. Thank you very much.

Medical Billing and Coding Forum

Table of Risk for inpatient stay with multiple physicians managing conditions

I need some help with the table of risk and whether it pertains to the patient’s risk or the provider. In the inpatient setting there may be multiple physicians managing the patient’s different conditions. So my question, for example, is if a patient is seen daily by an internist for say, pneumonia and also has stable stage 3 chronic kidney failure, and then develops acute kidney failure on top of that, and the AKI is now being managed by a nephrologist, the AKI falls into the high category for presenting problem, but since the internist is not the one managing the AKI can it still be counted as high on the table of risk for the internist?

Medical Billing and Coding Forum

Sleep Apnea – Medical Conditions That Causes Secondary Sleep Disorders

Some medical conditions can actually cause secondary sleep disorders. Aside from that, prescription medications used to treat your underlying medical conditions will cause you to develop secondary sleeping disorders. Such medical conditions would include gastroesophageal reflux disease, endocrine problems, cardiovascular diseases, kidney disorders, neurological problems and mental disorders, bone and joint problems such as arthritis, and respiratory problems.

Problems in the cardiovascular system can lead to sleeping disorders. These cardiovascular diseases would include congestive heart failure and coronary artery disease. In coronary artery disease, fat deposits accumulate in the walls of the blood vessels. These fat deposits are called as atheromas; thus, the condition being called as atherosclerosis. This condition would cause impeded blood circulation which leads to coronary artery disease. This condition would often lead to sleeping disorders such as sleep apnea. As for congestive heart failure, the patient’s heart is congested due to its inability to supply the requirements needed by the body; therefore, the heart’s workload is increased making it congested. Organs such as the kidney and the lungs are also greatly affected. Because of these conditions, the patient has a greater risk of developing sleep disorders such as obstructive sleep apnea.

Endocrine disorders such as thyroid gland problems and diabetes may also cause secondary sleeping disorders. In general, Diabetes can be considered as a multisystem disorder because it has a big impact on different body processes. Such processes would include metabolism of carbohydrates, proteins, and fats. Usually, restless leg syndrome is the sleeping disorder that occurs in people with diabetes. On the other hand, the thyroid gland is responsible for regulating the hormones that affect the level of energy in a person. Once the thyroid gland function is disrupted, major problems will likely occur. If there is an excessive secretion of hormones by the thyroid gland, the person would have episodes of waking up in the wee hours due to night sweats and will also have sleeping difficulties.

Aside from endocrine disorders, problems in the neurologic system can also lead to development of secondary sleeping disorders. Such neurologic problems would include epilepsy, Alzheimer’s disease, stroke, and Parkinson’s disease. Dementia and normal functioning is common among people with Alzheimer’s disease. Sleep fragmentation can also occur among people with Alzheimer’s disease. On the other hand, epilepsy is caused by electrical activities in the brain. Epileptic patients are at a greater risk to develop sleep disorder insomnia. As for Parkinson’s disease, it is a dysfunction in the central nervous system. People with Parkinson’s disease have motor problems and usually they suffer from tremors, muscle stiffness, posture problems, shuffling gait, and other normal activities. Aside from these motor problems, people with Parkinson’s disease are also predisposed to REM sleep behavior disorder and sleep onset insomnia.

Those who have respiratory problems such as chronic obstructive pulmonary disease and asthma are also predisposed to various sleeping disorders. Asthmatic patients have difficulties in breathing due to increased mucus production that causes airway obstruction as well as constriction and inflammation of the airway passages. Damage in the lungs that leads to difficulty in breathing is present in patients with chronic obstructive pulmonary disease. The most common sleeping disorder that these people develop are sleep fragmentation and often times, insomnia.

Mental problems such as bipolar disorder, schizophrenia, anxiety, and seasonal affective disorders are also prone to develop sleeping problems. These sleeping disorders would include sleep fragmentation and insomnia.

A condition called gastroesophageal reflux disease (GERD) is present among people who frequently experience acid reflux. Usually, the food that was previously ingested would regurgitate causing damage to the mucosal linings of the esophagus. For GERD, sleep fragmentation is likely to happen.

Problems in kidney functioning is troublesome because waste products are not eliminated. There will also be imbalances in the salt levels and water levels leading to serious problems like edema. Restless leg syndrome and insomnia are common among these people.

It is very evident that people with bone and joint problems are suffering from insomnia due to the fact that they are experiencing pain. An example of joint problem would be arthritis.

Secondary sleeping disorder is the term that is used to describe people who have sleep disorders caused by underlying medical conditions. When this happens, the best way would be to treat the medical condition first prior to treating the sleeping disorder itself.

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Overcome Infertilty – Medical Conditions Causes of Infertility

As we mentioned in previous articles, infertility is defined as inability of a couple to conceive after 12 months of unprotected sexual intercourse. It effects over 5 millions couple alone in the U. S. and many times more in the world. Because of unawareness of treatments, only 10% seeks help from professional specialist. In this article, we will discuss the medical condition causes of infertility.

1. Nervous disorder
Nervous disorder increases the production of certain hormone in the nervous system and the glands leading to hormone imbalance and interfering the normal procedure of menstrual cycles in women and lowering sperm count in men, leading to infertility.

2. Hypogonadotropic hypopituitarism
It is types of disease which interferes with the production of LH and FSH of the pituitary gland causing ovulation problem in women and low sperm count in men.

3. Immune disorder
Malfunction of immune system interferes with the reproductive process including the inflammation to cells which are vital involved in the processes of ovulation , preparation for implantation of a embryo ( malfunction of endometrial lining) and sperm quality ad quantity (Antibody attack his own sperm).

4. Pelvic inflammation disease (PID)
PID is defined as a condition of an acute infection in the pelvic caused by sexual transmitted diseases leading infertility if the scar forming in the Fallopian tube blocks the tube completely.

5. Pituitary tumor
Pituitary tumor is defined as a condition of benign overgrowth of cells in the pituitary gland causing abnormal function in secreting hormone, leading to over production of growth, thyroid-stimulating, prolactin hormones, etc. disrupting the normal processes of the reproductive organs thereby, increasing the risk of infertility in both men and women.

6. Testicular cancer
Testicular cancer is defined as abnormal cells growth become cancerous in the testicle. The cause is unknown but researchers believe men with poor quality of sperm production is considered as high risk to develop testicle cancer than other who do not.

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Chronic Bronchitis Medical Conditions And Symptoms

Chronic bronchitis is a serious condition affecting the airway passages of the lungs. The condition is an inflammation of the airway passages traveling to the lungs that is recurrent and leads to lung degeneration or disease. It is due to long-term exposure of the airways to irritants. This article will share the medical symptoms diagnosis and treatment options for dealing with this persistent infection.

Chronic Bronchitis Symptoms and Causes

The chronic form of bronchitis is largely concerned with transformations in the bronchi, particularly hyper-secretion of mucus and damage brought on by infection. It is caused by a repetitive irritation of the airways. This irritant is most commonly tobacco smoke. Various irritants include air pollutants, chemical compounds, or bacterial infections.

Indications of the sickness tend to start in smokers after age 50. Signs of bronchitis may be equivalent to those of various respiratory sicknesses. For this reason it’s critical to see a health-related medical doctor so a suitable diagnosis can be built and to distinguish bronchitis from various ailments or to identify if the bronchitis is acute or chronic.

Indications include a prolonged coughing (lasting months to years), which generates thick sputum (mucus secretions), and shortness of breath.

Chronic Bronchitis Analysis and Treatments

Signs and symptoms may be similar to various respiratory difficulties; for that reason it is suggested that the individual must seek advice from a medical provider. The doctor should perform a physical examination to diagnose the condition. The exam may incorporate sputum culture, pulmonary analysis, and upper body x-rays. It may be necessary to rule out other conditions like bronchiectasis, tuberculosis, a tumor, or coronary heart disease before a correct analysis can be produced.

Remedy for this illness is complex and aims to alleviate signs or symptoms and decrease the chance of complications. Importance is placed on smoking cessation if that is the primary cause. A MD may prescribe anti-biotics if the cause is a chronic bacterial infection, bronchodilators to open up airways, or an expectorant to loosen mucus secretions. Chronic bronchitis can be treated successfully if there’s no root illness and the irritation is eliminated (such as smoking).

Chronic bronchitis may lead to Chronic Obstructive Pulmonary Disease (COPD) that is an incurable and chronic lung disease.

This is a serious medical condition and you will want to learn all you can about Chronic Bronchitis so you can be an active participant in your health care.

You can read more about this condition and use a free tool that walks you through your symptoms and leads you to an online diagnosis. Prepare yourself before your doctor’s visit and figure out what your symptoms means using this Medical Symptom Diagnosis Tool.