Question

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Inpatient admission: The patient was admitted with possible pyelonephritis; Her complaints were bilateral flank pain and chills. A contrast intravenous pyelogram was normal. Within two days of admission, the character of her pain changed somewhat in that it became primarily in the right upper quadrant. The physician documented in the progress notes that significant features of conversion hysteria were present and accounted for the patient's symptoms. On the third hospital day, the patient's IV was discontinued, lover function tests were rechecked, and antibiotics were discontinued. Later that day, she left abruptly saying she would not return. Discharge diagnoses: (1) Right upper quadrant abdominal pain, (2) conversion disorder. 2.Inpatient admission: The patient, a 19-year-old man, was transferred from another hospital with intractable headache. The accompanying CT scan was normal, but clinical symptomatology was suggestive of subarachnoid hemorrhage. Lumbar puncture, non-contrast bilateral internal carotid cerebral arteriogram, and contrast cerebral MRI were all normal. When the findings were discussed with the patient, he became increasingly belligerent. Although his headaches were only somewhat improved, he refused further treatment and was discharged for follow-up with his own physician. Discharge diagnosis: Headache 3.Dysuria; Transurethral biopsy of bladder 4.Inpatient admission: The patient has a known diagnosis of prostatic cancer. He started having fevers approximately one week earlier. The fevers did not respond to outpatient antibiotics. Blood and urine cultures showed no growth. He was admitted for workup of the fevers with possible prostatic abscess formation. There were no obvious signs of infection or abscess on a transrectal ultrasound of the prostate. An iodine-123 radioisotope bone scan of the body revealed no skeletal metastasis. The antibiotic therapy was changed, and he was given an IV push. He improved and was discharged. Discharge Diagnoses: (1) Fever of unknown origin, (2) cancer of the prostate 5. Inpatient Admission: This HIV-positive patient was admitted with skin lesions on the chest and back. Biopsies were taken, and the pathologic diagnosis was Kaposi’s sarcome. Leukoplakia of the lips and splenomegaly were also noted on physical examination. Discharge Diagnoses: (1) HIV Infection; (2) Kaposi’s sarcoma, back and chest; (3) Leukoplakia; (4) splenomegaly 6. Inpatient Admission: The patient fell at his single-family home and was unable to get up. Neighbors found him several hours later, and he does not remember any circumstances surrounding the event. Blood sugars were monitored, and a diagnosis of diabetes mellitus was given. It became rapidly evident to the attending physician that, even with dietary restriction, the patient would need insulin therapy to lower his blood sugar level. Insulin therapy was started. The only other positive finding was beta-Streptococcus group B, which grew from the urine culture and was treated with oral antibiotics. Discharge diagnoses: (1) New onset type 2 diabetes mellitus, out of control (2) urinary tract infection with beta-Streptococcus 7. Kaposi's sarcoma of oral cavity, AIDS, Biopsy of oral cavity mucosa 8. Inpatient admission: The patient, an obese male, was admitted with generalized abdominal pain suggestive of early appendicitis, although he had a normal white count and normal differential. An intravenous pyelogram and X-ray of the lower gastrointestinal tract with barium enema were negative. All laboratory studies were normal. He improved while in the hospital without a definite cause for his pain ever being identified. He was placed on a low-fat, 1,500-calorie diet prior to discharge. Discharge diagnoses: (1) Abdominal pain of undetermined origin, generalized, (2) obesity. 9. Depression with anxiety; Conversion disorder (convulsion) I need assistance with these 9 coding questions. I have tried on my own to no avale.

Answer 1