Wiki Answer for Case#12

[Mitchell2]

I do not see how ICD-9 250.60 and 357.2 were derived. I have read the case twice. Can you tell me how this diagnosis was determined?

The knee is not considered the lower leg. Everything below the knee is the lower leg and everything above the knee is the upper leg. Therefore, shouldn't the answer be 715.39?

 

[lec121661]

case 12

I do not see how ICD-9 250.60 and 357.2 were derived. I have read the case twice. Can you tell me how this diagnosis was determined?

The knee is not considered the lower leg. Everything below the knee is the lower leg and everything above the knee is the upper leg. Therefore, shouldn't the answer be 715.39?

I agree and where did they get the lab codes from?

 

[alex.mckinley@aapc.com]

FYI: I just posted the rationale in the case #12 thread.

 

[martnel]

I do not see how ICD-9 250.60 and 357.2 were derived. I have read the case twice. Can you tell me how this diagnosis was determined?

The knee is not considered the lower leg. Everything below the knee is the lower leg and everything above the knee is the upper leg. Therefore, shouldn't the answer be 715.39?

Did you mean 715.38?
715.38 Localized osteoarthrosis not specified whether primary or secondary, other specified sites

715.39 does not come up in 2015 ASCEXPERT, but in my older ICD 9 book it refers to "multiple sites" ?

 

[Etb11308069]

Case 12

For the Diabetes the physician states Although his diabetes appears to be well controlled at this point, i am concerned about the peripheral neuropathy he is experiencing this does not establish that the patient has peripheral neuropathy that is why he is sending the patient to the endocrinologist to confirm the diagnosis, so until the diagnosis is confirmed shouldn't you code just the diabetes 250.00. The patient only complains of occasional numbness of the fingers, which is a sign of neuropathy but again no confirmation on the nuropathy dx. Also how do you get a moderate MDM?

Also code V58.66 should be added.

Thank's for your help

 

[lec121661]

case #12

For the Diabetes the physician states Although his diabetes appears to be well controlled at this point, i am concerned about the peripheral neuropathy he is experiencing this does not establish that the patient has peripheral neuropathy that is why he is sending the patient to the endocrinologist to confirm the diagnosis, so until the diagnosis is confirmed shouldn't you code just the diabetes 250.00. The patient only complains of occasional numbness of the fingers, which is a sign of neuropathy but again no confirmation on the nuropathy dx. Also how do you get a moderate MDM?

Also code V58.66 should be added.

Thank's for your help

I agree, I would have never coded the lab why was that included? I also coded the v58.66

 

[Mitchell2]

Did you mean 715.38?
715.38 Localized osteoarthrosis not specified whether primary or secondary, other specified sites

715.39 does not come up in 2015 ASCEXPERT, but in my older ICD 9 book it refers to "multiple sites" ?

Yes. I did mean 715.38.

 

[Mitchell2]

The knee is not considered the lower leg. Everything below the knee is the lower leg and everything above the knee is the upper leg. Therefore, shouldn't the answer be 715.39?[/QUOTE]

 

[mitchellde]

FYI: I just posted the rationale in the case #12 thread.

Alex, you cannot code the BMI as it is not documented. The guidelines specify that the BMI must be documented in the chart, and can be documented by any qualified person in the office. In addition the level of BMI and the level of obesity must match. There is no BMI documented in this note so it cannot be coded. Or did I not see it??

 

[ajgibson]

Alex, you cannot code the BMI as it is not documented. The guidelines specify that the BMI must be documented in the chart, and can be documented by any qualified person in the office. In addition the level of BMI and the level of obesity must match. There is no BMI documented in this note so it cannot be coded. Or did I not see it??

You just missed it. It is in the EXAM portion in the vitals. Just after the weight of "298lbs".