HI253: Medical Coding

INSTRUCTIONS: Respond to post. Response should be on topic, original and contribute to the quality of the discussion. It should be thoughtful and advance the discussion. Refer to attached rubric for grading guideline.

CLASSMATE POST #1

Below I will discuss multiple codes from AAPC ICD-10-CM chapter 21 “Z codes” that have related to having children, it is amazing how we take our kids to the doctors but had never thought about the billing process until this class.

My sixteen-year-old daughter has hypotension and we use to have to go to the doctor’s office for them to check it and record how low her blood pressure was. The first code I will discuss is Code Z01.3 “Encounter for examination of blood pressure” I feel this is probably used quit a bit in the physician’s office not just for children but all ages. After reviewing this code right beside the Z01.3 code you will see that it says it requires a 5^th character. There are two codes with five characters below Z01.3 that can be used:

1. Z01.30 Encounter for examination of blood pressure without abnormal findings
2. Z01.31 Encounter for examination of blood pressure with abnormal findings.

With my daughter’s circumstances, code Z01.31 would had been used. Under that code it reads “use additional code to Identify any abnormal findings.” So, they would have use code Z01.31 and a code for the Hypotension when coding my daughter’s visits.

One screen test code that was used for one of my youngest son’s doctor visit, was Z13.1 “Encounter for screening for diabetes mellitus.” Urine and blood were obtained during this visit, to verify if his health issues at that time could had been diabetes mellitus. Thank goodness it was not.

What about other codes that might had been used for my children’s visits throughout their school years. Like physicals for my sons’ football or my daughter’s softball. Or when all four of my children had to have physicals to enter kindergarten. The two codes to cover these types of visits are both under Z02 “Encounter for administrative examination” and are listed below.

1. Z02.0 Encounter for examination for admission to educational institute
2. Z02.5 Encounter for examination for participation in sport

All these codes discussed here are under the Z codes and were used at least once throughout my children’s school age years. Now every time I take my child to the doctor, I am going to be coding the encounter just to learn.

~Barbie Merrell~

CLASSMATE POST #2

Z codes are designated as the principal/first listed diagnosis in specific situations such as: to indicate that a person with a resolving disease, injury or chronic condition is being seen for specific aftercare, such as the removal of internal fixation devices. They are represented by codes Z00-Z99. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as ‘diagnoses’ or ‘problems’. This can arise in two main ways: When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury; when some circumstance or problem is present which influences the person’s health status but is not in itself a current illness or injury. Z16-Resistance to antimicrobial drugs. This code indicates that a patient has a condition that is resistant to antimicrobial drug treatment. Z21-Asymptomatic HIV infection status This code indicates that a patient has tested positive for HIV but has manifested no signs or symptoms of the disease. Z33.1- Pregnant state, incidental. This code is a secondary code only for use when the pregnancy is in no way complicating the reason for visit.

~Jessica Darby ~

SC121: Human Anatomy and Physiology

INSTRUCTIONS: Respond to post. Response should be on topic, original and contribute to the quality of the discussion. It should be thoughtful and advance the discussion. Refer to attached rubric for grading guideline.

CLASSMATE POST #3

Marfan syndrome is caused by a defect in the gene that enables your body to produce protein fibers that support and anchor your organs and other structures. Therefore, the most common symptom of Marfan syndrome is a tall and slender build, with disproportionately long arms, legs, and fingers (Mayo Clinic, 2019). Other symptoms include a breastbone that protrudes outward or dips inward, a high, arched palate and crowded teeth, heart murmurs, extreme nearsightedness, an abnormally curved spine (scoliosis), and/or flat feet (Mayo Clinic, 2019).For this week’s discussion post, I researched a disorder I have never heard of – Marfan syndrome. This is an inherited disorder of the connective tissue (Mayo Clinic, 2019). The normal functions of connective tissue are to bind together, support, and strengthen body tissue; protect and insulate internal organs; compartmentalize structures such as skeletal muscles; serve as the major transport system within our body; is the primary location of stored energy reserves; and is the main source of immune responses (Derrickson, 2017). Connective tissue is made up of extracellular matrix and cells. The extracellular matrix consists of protein fibers and ground substance (Derrickson, 2017).

There is no cure for Marfan syndrome, therefore treatment focuses on preventing complications from the disease (Mayo Clinic, 2019). Treatment then varies depending on the complications you may experience. Such as blood pressure medication to help prevent the aorta from enlarging; glasses or contacts to correct a dislocated lens; scoliosis treatment like a brace or surgery; and/or avoiding competitive sports (Mayo Clinic, 2019). Other treatment we may not immediately think of includes emotional support. Living with a genetic disorder can be extremely difficult (Mayo Clinic, 2019). Specifically, young people may have cosmetic concerns that can be fixed rather easily via contact lenses instead of glasses, a brace for scoliosis, dental work for crowded teeth, and/or clothes that flatter a tall, thin frame (Mayo Clinic, 2019). In the long run, accurate information about the disease, good medical care, and strong social support can help both children and adults cope with Marfan syndrome (Mayo Clinic, 2019).

~Abbie Boes~

CLASSMATE POST #4

The disorder that I researched was Osteogenesis Imperfecta. Osteogenesis Imperfecta is a rare disorder that affects the bones (Johns Hopkins Medicine, 2020). OI has also been dubbed “Brittle Bone Disease”. Bones are made up of connectives tissue. Bones have several functions in our bodies such as body support, facilitation of movement along with our muscles, and contains blood forming tissues (Derrickson, 2016). Our bones also protect our inner organs. This devastating illness is caused by a defective gene that normally produces the protein collagen which forms and strengthens bones. Because of the mutation of the gene, there is not enough collagen in patients with OI.

Unfortunately Osteogenesis Imperfecta is hereditary and is present upon birth to those that are affected. There are at least 8 types of OI ranging in severity and each type has numerous symptoms associated with it. These symptoms include soft brittle bones that break easily, bone deformities, loose joints, muscle weakness, curvature of the spine and soft teeth discolored teeth (Johns Hopkins Medicine, 2020). In addition to symptoms that directly affect the bones, this illness presents other symptoms that do not affect the bones. For instance, some people with OI present with a triangle shaped face, a barrel-shaped chest, and a discoloration of the sclera (white part of the eye), and skin that easily bruises (Johns Hopkins Medicine, 2020). Some people may also experience hearing loss during early adulthood.

Sadly enough there is no cure for Osteogenesis Imperfecta. Patients afflicted with OI can merely treat and manage their symptoms throughout their lives. The main treatment is preventing deformities and fractures (Johns Hopkins Medicine, 2020). Some patients find relief with braces and splints, and or using assistive devices such as wheelchairs. These patients may end up with multiple surgeries throughout their lifetime in order to set fractures as well as dental procedures to correct dental issues. A procedure called rodding may be used. Rodding is a procedure in which a rod is inserted into a patient to offer support for long bones. Physical and occupational therapy are beneficial to these patients.

~Angela Fletcher~