Question

eoplasms Ne ischarge Summary Date of Admission: Date of Discharge: Discharge Diagnosis: 2/3 2/4 Malignant ascites from metastatic adenocarcinoma of the colon . This 59-year-old white female patient was admitted for continuous rapy with 5-FU and Leucovorin. Patient had a central venous catheter the superior vena cava which was used for the chemotherapy treatment. This place under the care of Dr. ZXY. The patient tolerated her chemotherapy very s done She had no complication be followed further as an outpatient by her oncologist. r chemotherapy very well. s throughout her hospital course, and she was discharged to Instructions on Discharge: Follow up in the office History and Physical Admitted: 2/3/20XX Reason for Admission: Chemotherapy History of Present IlIness: The patient is a 59-year-old white female with peritoneal carcinomatosis and malignant ascites from colon carcinoma. She is admitted for continuous chemotherapy. The patient has a sigmoid colostomy and has had multiple nal surgeries for carcinoma; the first one was an anterior and posterior repair in 1982. She had six weeks of radiation therapy completed two years ago and has been on weekly chemotherapy consistina of 5-FU and methotrexate recently. Because of ncreasing abdominal girth, she was admitted in June and diagnosed with malignant 20

Answer 1

Principal diagnosis: colon cancer code-C18.9

Additional diagnosis:Peritoneal carcinomatosis-C78.6

Malignant Ascites-R18.0

Procedure code: Intravenous infusion of chemotherapy-96416

Hydraytion-96360