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Recent Scenarios


May 15, 2015
Test your coding knowledge with this scenario about coding bilateral upper eyelid with ICD-9, ICD-10... Learn More

April 24, 2015
Test your coding knowledge with this scenario about coding prostate cancer with ICD-9-CM, CPT, and H... Learn More

April 10, 2015
Test your coding knowledge with this scenario about coding right colon mass with ICD-9-CM, ICD-10-CM... Learn More

 
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Code This!

2012 Code This Scenarios
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December 20, 2012 -

Preoperative Diagnosis: Nuclear sclerotic and cortical cataract, right eye

Postoperative Diagnosis: Same


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November 29, 2012 -

CHIEF COMPLAINT: Pregnant patient with fever, nausea and vomiting


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November 15, 2012 -

SCENARIO: A 65-year-old patient presents to the emergency room with right shoulder pain and fever. The patient is five days status post steroid injection of preservative-free Methylprednisolone Acetate 80 mg/ml for shoulder pain and immobility due to localized primary glenohumeral joint osteoarthritis with chronic adhesive capsulitis. Records match CDC confirmation of contaminated product as one of three implicated drug lots currently under recall.


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October 25, 2012 -

Scenario: A 45-year-old patient presents for laparoscopic cholecystectomy. Outpatient ultrasound is positive for multiple cholelithiasis


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October 04, 2012 -

CHIEF COMPLAINT: Headache, fever

SCENARIO
A 62-year-old patient presents to the emergency room with worsening headache and flu-like illness. Symptoms of fever, severe headache, lethargy, body aches, and nausea progressed steadily over the past week. Severity of symptoms prompted the patient’s visit to the emergency room.


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September 21, 2012 -

Scenario: A 47-year-old male patient presents to the emergency department with a 5-hour history of severe nausea, vomiting, abdominal cramping, and diarrhea beginning several hours after eating at a fast-food restaurant. His diagnosis is gastroenteritis due to food poisoning, presumed to be bacterial.


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September 06, 2012 -

Blepharoplasty and ptosis repair

Preoperative diagnosis: Bilateral ptosis
Procedure: Bilateral ptosis repair, bilateral blepharoplasty


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August 30, 2012 -

Assign the appropriate ICD-9-CM diagnosis and procedure codes as well as CPT for the following outpatient scenario:

Operative report: Endoscopic ultrasound
Needle aspiration of pancreatic cyst


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August 10, 2012 -

Diagnosis: Xanax overdose
Change in mental status
Cocaine use
Alcohol use
Lethargy
History of suicide attempts
Allergy to Vicodin


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July 27, 2012 -

HISTORY:
Chief complaint
: This is a male patient who is 86 years of age. He presents as a new patient today for complaints of right lateral ulcer, nail, and foot care.
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July 12, 2012 -

Preoperative diagnosis: 2 cm mass in tail of pancreas – presumed neuroendocrine tumor

Postoperative diagnosis: 2 cm mass in tail of pancreas – pathology pending

Operation performed: Robotically assisted laparoscopic distal pancreaticosplenectomy


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June 28, 2012 -

Preoperative Diagnosis: Shortness of breath, chronic cough, and weight loss

Postoperative Diagnosis: Same

Operation: Bronchoscopy


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June 15, 2012 -

Preoperative Diagnosis: Nevus, forearm

Postoperative Diagnosis: Same


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June 01, 2012 -

Preoperative Diagnosis: Infected right third toe open wound, nonhealing with exposed bone

Postoperative Diagnosis: Same

Procedure Performed: Amputation at the metatarsophalangeal joint of the right third toe


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May 18, 2012 -

Preoperative Diagnosis: Foreign body, right thigh

Postoperative Diagnosis: Same

Indications:
A 9-year-old male was stabbed in the right thigh with a stick while playing. The area of the injury is sore and the patient’s mother thinks there is still a foreign body in the wound. The mother tried to get out the sliver of wood but according to the mother it was too painful. Plan to remove FB thigh.


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May 04, 2012 - Preoperative Diagnosis: Multiple gunshot wounds with foreign bodies in the back and neck area.

Postoperative Diagnosis: Multiple gunshot wounds with foreign bodies in the back and neck area.

Operation:
1. Debridement of gunshot wound of the left deltoid
2. Removal of foreign body from the posterior neck
3. Removal of foreign body from the left upper back-parascapular – medial border of the scapula


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April 20, 2012 -

Preoperative Diagnosis: Actinic keratosis

Postoperative Diagnosis: Actinic keratosis

Operation: Freezing of lesions with liquid nitrogen


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April 05, 2012 -

Preoperative Diagnoses:Second-degree atrioventricular block Bradycardia

Postoperative Diagnoses: Same

Procedure: Implant dual chamber pacemaker under fluoroscopic guidance


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March 29, 2012 -

Preoperative diagnosis: Bilateral ptosis of upper eyelids
Postoperative diagnosis: Same
Operation performed: Bilateral external levator resection
Anesthesia given: Local monitored anesthesia care
Estimated blood loss: Negligible
Complications: None


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March 16, 2012 -

Preoperative diagnosis: Small bowel obstruction with perforated viscus.
Postoperative diagnosis:

  1. Small bowel obstruction with perforated viscus
  2. Ischemic small bowel

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March 01, 2012 -

Procedure
Ultrasound guidance for venous access
Tunneled port (age>5 years) placement
Fluoroscopic guidance placement


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February 02, 2012 - A 35-year-old male patient presents to the emergency room with blunt abdominal trauma due to an earlier accident, pedestrian versus motor vehicle (patient was the pedestrian). Patient has significant abdominal pain and tenderness and appears hemodynamically unstable, so the emergency room physician decides to go forward with an ultrasound guided peritoneal lavage to determine if there is blood in the peritoneal cavity.
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January 18, 2012 -

OPERATIVE REPORT:
Ascending aortic replacement with sinotubular junction normalization and aortic valve resuspension with #28 Vascutek gelweave graft. Proximal arch replacement with island anastomosis and heavy beveling of lesser curvature on deep hypothermic circulatory arrest with retrograde cerebral protection using #28 Vascutek gelweave graft. Transesophageal echocardiogram.


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January 04, 2012 -

Preoperative Diagnosis:
Mass lesion, left lower pole of thymus, with a question of a thymoma

Postoperative Diagnosis:
Enlarged and lymphatic appearing thymus gland, large, left lower pole of thymus


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