Page 1 of 2 12 LastLast
Results 1 to 10 of 11

Evaluation & Management (CEMC) Round 5 #13 Note 5

  1. #1
    Default Evaluation & Management (CEMC) Round 5 #13 Note 5
    Exam Training Packages
    HELP!
    The assessment is this:
    (1) Diabetes (2) Chronic kidney disease (3) Need of dental care (4) Side effects from Victoza (5) Hypertension (6) Medication management (7) Hyperlipidemia
    PLAN: Refer to dentist and schedule mammogram. Return for labs. Follow-up in three months.

    Right, so I have 250.00,585.9,401.9,272.4. It will not let me enter anything that I have come up with, having to do with "side effects" (adverse reactions-I even tried entering the symptoms the patient was having from the hpi), nothing for medical management (v58.69?), and goodness knows I can't find anything to use for "needs to see a dentist". I've called the AAPC several times and have been told "someone will call you back", and apparently, no one will call until the end of the day. I've had two other certified coders look at this chart and they're stumped too. What am I not seeing?!

  2. Unhappy
    I'm having the same problem with round 3. Did you by chance, complete round 3.
    chart
    HISTORY OF PRESENT ILLNESS: Patient presented with hair spray exposure to right eye.
    REVIEW OF SYSTEMS: Complains of pain. No fever, nausea or vomiting.
    EXAMINATION: HEENT: Bilateral ear canals: ear drums normal. Oropharynx: unremarkable. Fluorescein stain done of right eye: shows 1 ml area of corneal abrasion. Bilateral pupils reactive. Anterior chamber bilaterally normal. CHEST: Bilateral good air entry, clear to auscultation, no rales, rhonchi, rubs, normally resonant. CVS: CVS — S1, S2 positive, normal split, no thrills, bruits, rubs or murmurs. ABDOMEN: Soft, non-tender, no organomegaly, no free fluid, no abnormal masses, no rebound. CNS: AAO x 3, no focal neurological deficits, no cranial nerve deficits, no cerebellar or meningeal signs, bilateral power 5/5.
    ASSESSMENT: Right eye corneal abrasion.
    PLAN/EDUCATION: Ciprofloxacin ophthalmic 2 drops q2h while awake x 2 days, then q4h while awake x 5 days. Use dark glasses. Follow up in one week. May take Ibuprofen or Ultram for pain.
    I have cpt 99202 and icd-9 code 918.1 for the corneal abrasion. I can not get the system to take anything for the exposure of hairspray to the eye? The only other thing I could think to code is for the fluorescein stain, but from what I have seen, that is included in the office visit. So sorry for posting a question to your question, just hoping you could point me to the right direction. I'm a little frustrated to say the least. I hope someone is able to help you with your question.
    Thanks
    Lorri CPC-A

  3. Default
    Quote Originally Posted by JamieGalloway View Post
    HELP!
    The assessment is this:
    (1) Diabetes (2) Chronic kidney disease (3) Need of dental care (4) Side effects from Victoza (5) Hypertension (6) Medication management (7) Hyperlipidemia
    PLAN: Refer to dentist and schedule mammogram. Return for labs. Follow-up in three months.

    Right, so I have 250.00,585.9,401.9,272.4. It will not let me enter anything that I have come up with, having to do with "side effects" (adverse reactions-I even tried entering the symptoms the patient was having from the hpi), nothing for medical management (v58.69?), and goodness knows I can't find anything to use for "needs to see a dentist". I've called the AAPC several times and have been told "someone will call you back", and apparently, no one will call until the end of the day. I've had two other certified coders look at this chart and they're stumped too. What am I not seeing?!
    You are forgetting that hypertension and kidney disease have a presumed connection without having to be stated as such (in the coding guidelines). Here are the codes I came up with:
    250.00
    403.90
    585.9
    272.4
    995.29
    V58.69
    E947.8
    E849.X

    If you can place the whole note with HPI, etc I can make sure I have given you the correct answers. Without it, this is all I have.

  4. #4
    Default
    Actually after calling the AAPC, and someone calling me back, we got it sorted out. The doctor didn't specifically make a connection between the DM, HTN, or CKD (I know, in the real world, one might do that, but not with this, apparently). V58.69 was also not being accepted. It was an E code for the synthetic insulin (Byetta, etc) and actually a WRONG code for flatulence (the side effect). I was coding 787.3, and their coder coded it as some unspecified disorder of the stomach (the exact code escapes me right now).

  5. #5
    Default
    Quote Originally Posted by jimlorri View Post
    I'm having the same problem with round 3. Did you by chance, complete round 3.
    chart
    HISTORY OF PRESENT ILLNESS: Patient presented with hair spray exposure to right eye.
    REVIEW OF SYSTEMS: Complains of pain. No fever, nausea or vomiting.
    EXAMINATION: HEENT: Bilateral ear canals: ear drums normal. Oropharynx: unremarkable. Fluorescein stain done of right eye: shows 1 ml area of corneal abrasion. Bilateral pupils reactive. Anterior chamber bilaterally normal. CHEST: Bilateral good air entry, clear to auscultation, no rales, rhonchi, rubs, normally resonant. CVS: CVS — S1, S2 positive, normal split, no thrills, bruits, rubs or murmurs. ABDOMEN: Soft, non-tender, no organomegaly, no free fluid, no abnormal masses, no rebound. CNS: AAO x 3, no focal neurological deficits, no cranial nerve deficits, no cerebellar or meningeal signs, bilateral power 5/5.
    ASSESSMENT: Right eye corneal abrasion.
    PLAN/EDUCATION: Ciprofloxacin ophthalmic 2 drops q2h while awake x 2 days, then q4h while awake x 5 days. Use dark glasses. Follow up in one week. May take Ibuprofen or Ultram for pain.
    I have cpt 99202 and icd-9 code 918.1 for the corneal abrasion. I can not get the system to take anything for the exposure of hairspray to the eye? The only other thing I could think to code is for the fluorescein stain, but from what I have seen, that is included in the office visit. So sorry for posting a question to your question, just hoping you could point me to the right direction. I'm a little frustrated to say the least. I hope someone is able to help you with your question.
    Thanks
    Lorri CPC-A


    my gosh YES I was stuck on this one for hours. And when I talked to the rep at AAPC, she agreed it was probably coded wrong; you want to code NOT for "foreign object in eye", which would make sense, but instead it coded to "poisoning by..." something...I don't recall the exact term. But thats what it was in, this after I punched in practically every code in the E section...!


    ETA: You're right, the stain is included in the E/M level. You're not missing a procedure code, just that funky "poisoning" code. Yeah. Good luck!!
    Last edited by JamieGalloway; 03-28-2011 at 10:00 PM. Reason: forgot something!

  6. Default
    Thanks so much Jaime. They sure don't make the charts easy.LOL. I even looked up ingredients in hairspray . I guess I'm back to looking for the E code again or maybe I will call the AAPC Thanks again

  7. #7
    Default
    Jimlorri, I sent you a private message just now, let me know if you get it!

  8. #8
    Location
    Galveston, Texas
    Posts
    5
    Default
    I'm still stuck with trying to figure out the right code for the hairspray. You're right. They don't make these easy for sure.

  9. #9
    Location
    Grand Rapids, MI
    Posts
    57
    Default
    What are all of you working on?

  10. Default NEED HELP ON Evaluation & Management (CEMC) Round 1
    HELLO ,
    I WAS WONDERING IF YOU CAN HELP WITH Evaluation & Management (CEMC) Round 1
    I am stuck on note 5 can you please help me .

Page 1 of 2 12 LastLast

Similar Threads

  1. ob/gyn code a round round 1 note 4
    By allyson815@gmail.com in forum OB/GYN
    Replies: 5
    Last Post: 08-15-2012, 01:46 PM
  2. Evaluation & Management
    By venkatbpt2000 in forum Medical Coding General Discussion
    Replies: 4
    Last Post: 05-21-2012, 01:04 AM
  3. Evaluation & Management Frequency Distribution
    By GENOWAL in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 02-24-2012, 04:48 PM
  4. AAPC OBGYN code a round, round 1 note 5
    By cyndiann in forum OB/GYN
    Replies: 3
    Last Post: 01-03-2012, 05:45 PM
  5. Evaluation & management
    By MANNLM in forum E/M
    Replies: 3
    Last Post: 02-25-2010, 04:16 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.