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-219075-5619752018 LTC CODING EXERCISESANSWER KEYAssign code(s) and sequence in correct order1.Acute cystitis due to E. coli infection2.Diabetic neuralgia due to type 2 diabetes mellitusPatient on insulin3.Acute and chronic pyelonephritis4.Stroke two years ago with residual hemiplegia of rightdominant side-Is this sequale or late effect5.Noncompliance with medication, unintentional due toresident’s advance age 6.Persistent Atrial FibrillationLong term use of anticoagulants7. Sepsis due to MRSA8.End of life care 9.Agranulocytosis due to HIV infection10.Chronic kidney disease, Stage IV due to type 1Diabetess11.Type 1 diabetic developed hypoglycemia even though she had taken only the prescribed dose of insulin and did not alter eatingregimenConfidential and privileged, all rights reserved, “Lutz”2018 LTC CODING EXERCISESPage 212.Aftercare following knee replacement surgery, left knee 13.Chronic neoplasm related pain (look under pain, then chronic) 14.Multiple sclerosis 15.Severe depression, recurrent16.Aplastic anemia17. Alzheimer’s disease, late onset18. Lobar pneumonia with influenza19. Aspiration pneumonia due to aspiration of vomitus20. Chronic obstructive lung disease with acute exacerbation“Confidential and privileged, all rights reserved, Lutz”2018 LTC CODING EXERCISESPage 32018 LTC Coding Scenarios1.This long term care multiple sclerosis patient was admitted for continuing long term antibiotic therapy for a urinary tract infection due to E coli2.This patient sustained a fractured pelvis due to a fall from his moving electric Wheelchair while in the nursing home where he resides due to multiple sclerosis;Patient is readmitted to the nursing home from the hospital. The patient also hasMultiple chronic illnesses to include Hypertension, Hyperlipidemia, Diabetes Mellitus, Atrial Fibrillation, COPD. Patient is on insulin, Coumadin and oxygen3.This 48 year old male patient was admitted for PT and OT to maintainstrength for Parkinson’s disease. He requires continued monitoring and is not able to live alone.He also has Type 1 Diabetes and COPD4.This patient was hospitalized for a below the knee amputation of the left leg. Following surgery he developed an infection of the amputation stump which wastreated during the hospitalization and the antibiotics were complete at the time of discharge.The patient is now admitted to the nursing facility to monitor for healing, signs of Infection, and to perform dressing changes“Confidential and privileged, all rights reserved, Lutz”2018 LTC CODING EXERCISESPage 45.Patient was admitted to the nursing home following hospitalization for acute osteomyelitis and gangrene due to a chronic nonhealing stage 3 decubitus ulcer of the right ankle. Antibiotic therapy is continued. The patient is type 1 diabetic with peripheral vascular disease due to the diabetes. The patient also has stage 4 chronic kidney disease, hypertension and is status post left knee amputation. PMH also includeshypercholesterolemia and chronic alcoholism which is in remission6.This patient is being treated for a pathological fracture of the right humerus due to severe senile osteoporosis; The fracture was previously diagnosed during andacute care hospital stay. Other diagnoses include: Vitamin D deficiency, Hypothyroidism, Chronic bronchitis with decompensated COPD, Depression, Anxiety, Celiac diseasewith pancreatic insufficiency“Confidential and privileged, all rights reserved, Lutz”2018 LTC CODING EXERCISESPage 57.This 75 year old woman was taken to the emergency room after being found semi-conscious with markedly abnormal vital signs, a fever of over 39 degrees C, a heart rate of 100 and arespiratory rate of 22/min. On admission to the ICU the physician documented her condition as severe sepsis with acute respiratory failure. The final diagnosis provided by the physician was gram-negative sepsis with acute respiratory failure. The patient also had the following diagnosis:Failure to thrive, Senile dementia, Atherosclerotic Heart Disease, Chronic diastolic congestive heart failure8.61 year old female patient with small cell carcinoma of the right lower lobe of theLung with metastasis to the intrathoracic lymph nodes, brain and right rib; History ofBreast cancer, anemia in neoplastic disease“Confidential and privileged, all rights reserved, Lutz”2018 LTC CODING EXERCISESPage 69. This elderly patient was admitted for the treatment of cellulitis of the right lower extremity. The cultures grew streptococcus B and was documented by the physician to be the cause of the cellulitis. Patient also has a stage 1 decubitus ulcer on the left buttock and stage 2 decubitus ulcer of the right gluteal region10. 85 year old admitted to the nursing facility following hospitalization for dehydrationdue to pneumonia. Resident is admitted for multiple therapies due to weakness dueto the infiltrates. He will complete the antibiotics in the Nursing home for Pseudomonaspneumonia. Resident also has progressing dementia resulting from Parkinson’s disease and he realized it is getting more difficult to stay in his home and agreed to the admission. His pastmedical history includes: Mitral valve regurgitation, kyphosis, mild asthma and type 2 diabetes“Confidential and privileged, all rights reserved, Lutz”11.This nursing home resident is admitted following a hospital stay for an acute cerebral infarction. The resident will receive multiple therapies for the resulting left hemiplegia of the nondominant side, dysphasia and facial droop. Other admitting diagnoses include GERD, rheumatoid arthritis and early onset Alzheimer’s disease with Dementia and aggressive behavior 12.Patient admitted after a fall off her porch at her single family home while sweeping. A femoral Intertrochantericfracture was diagnosed on the right side and she was admitted for surgery. She had an open reduction and internal fixation. She was admitted to the Nursing Home for therapy ................
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