MDC3 MDC4

1.(Streptococcus)(Neisseria)

2.

3.

1. : A02.22 Salmonella pneumonia

J15.211 Pneumonia due to staphylococcus aureus

: I00+J17 Pneumonia in rheumatic fever

2. (1):

(2) 25-50%

(3): J15.0 Pneumonia due to Klebsiella pneumoniae

J15.6 Pneumonia due to other aerobic Gram-negative bacteria

G(-)

RW1.0250

G(-)

J18.9

RW0.5546

1.

2.G(-)

3.:

(1)J69.0

(2)J69.1

(3)J15J12

RW0.8311

J18.9

RW0.5546

VAP,Ventilator-Associated Pneumonia

1.J95.851 Ventilator associated pneumoniaB95~B97

2.J12~J18:

VAP due to Staphylococcus aureus

J95.851+B95.61(Methicillin)

J95.851+J15.211

VAP,Ventilator-Associated Pneumonia 3.VAP

J12~J18 VAP J95.851

RW0.4392

RW2.1665

Influenza

1.J09J10 (1)J09.X-avian influenza bird influenza A/H5N1 influenzaswine influenza other animal origin (2)J10Influenza due to other identified influenza virus 2.:Suspected, Possible, Likely ,? J09J10 J11 Influenza due to unidentified influenza virus

Acute laryngitis and tracheitis

1.J04

J04.0 Acute laryngitis

J04.1 Acute tracheitis

J04.2 Acute laryngotracheitis

J04.3 Supraglottitis, unspecified

2. Supraglottitislingual tonsilla areaepiglottic foldfalse vocal cordepiglottis

Asthma

1.

2.wheezingdyspneaexertion

cough

3.J45

4 2 mild interment

3 mild persistent

4 moderate persistent

5 severe persistent

9 unspecified or other

0 uncomplicated

1 (acute)exacerbation (C.C.)

2 status asthmaticus (C.C.)

: J45.22Mild intermittent asthma with

status asthmaticus

Asthma 4.

respiratory failure with hypercapnia

:

(1)intractable asthma attack,

(2)refractory asthma,

(3)sever, intractable wheezing,

(4)airway obstruction not reliveed by bronchodilators,

(5)severe, prolonged asthma attack.

5.

:

(1)

(2)adrenal corticosteroids

6. 12

2

Pleural effusion 1.(underlying disease)J91.8 Pleural effusion in other conditions classified elsewhere

2.

Pleural effusion Coding clinic second quarter 2015 p.15

Q:Coding Clinic has previously advised that pleural effusion in congestive heart failure(CHF) is ordinary minimal and not specifically addressed other than by more aggressive treatment of the underlying CHF. Is it appropriate to assign code J91.8, for pleural effusion due to CHF? How is pleural effusion in CHF be coded?J91.8?

A:Code J91.8, is assigned as a secondary code only if the condition is specifically addressed and treated. .Ordinarily the pleural effusion is minimal and is not specifically addressed other than by more aggressive treatment of the underlying CHF. In this situation it should not be coded. However, it is acceptable to report pleural effusion(J91.8) as an additional diagnosis if the condition requires either theraputic intervention or diagnostic testing. J91.8

BAL(Bronchoalveolar lavage)

washingbrushing (BAL)

bronchoscopenormal saline brushmucosa

biopsy

Coding clinic first quarter 2016 p.26

Q:A bronchoscopy is performed, bronchoalveolar lavage(BAL), bronchial washings and ctyology brushing were obtained in the right upper lobe bronchus; endobronchial biopsies from the right upper lobe. Should the BAL and brushings be seperately coded?

A:ICD-10-PCS dose not provide the Extraction root operation value for bronchial

brush biopsies the root operation Excision is the closedt available equvalent.

BAL-Drainage

Washing()-Excision

Brushing-Excision

0B948ZX Drainage of upper lobe bronchus, via natural or artificial opening

endoscopic, diagnostic, for the bronchoalveolar lavage of the upper lobe.

0BB48ZX Excision of the upper lobe bronchus, via natural or artificial opening

endoscopic, diagnostic, for the right upper lobe brush biopsies, washings

and endobronchial biopsies.

otitis 1.Otitis(chills)

(drainage from the ear), , (buzzing)

2.Otitis(external ear)(middle ear)

H60 Otitis externa

H61 Other disorders of external ear

H62 Disorders of external ear in

diseases classified elsewhere

H65 Nonsuppurative otitis media

H66 Suppurative and unspecified otitis

media

H67 Otitis media in diseases classified

elsewhere

Otitis(media)

Suppurative Non Suppurative Unspecified

Acute Chronic Unspecified

Right Left Unspecified

otitis media

? Respiratory failure 1.(hypercapnia)(hypoxia):

? Respiratory failure 2.J95.82-Postprocedural

respiratory failure 3.(:)

:A patient with emphysema develops acute respiratory failure. The patient is admitted thruoght the ER for treatment of the respiratory failure.

PDx: J96.00

SDx: J43.9

4.:

(1)

(2)(:HIV Tabular list):

? Respiratory failure

:

? Respiratory failure

:T36-T50

? Respiratory failure

HIV:HIVHIVHIVB20

? Respiratory failure

Tabular list:R65.2Tabular listA41.9

? Respiratory failure

: (1)A patient is admitted to the hospital postpartum as a

result of developing pulmonary embolism leading to respiratory failure.

PDx: O88.23 SDx: J96.00

(2)A patient is admitted to the hospital with the sever Staphylococcus aureus sepsis and acute respiratory failure.

PDx: A41.01 SDx: R65.20 J96.00

? Respiratory failure

1.BIPAPPCSAssistance(taking over a portion of a physiological function by extracorporeal means)

2.PCSPerformance(Compeletly take over the physiological function of breathing by extracorporeal means )

3.:

(1)

(2)

(3)

4.: (1) (2) (3) 5.: (1) (2) (3)

6.

7.48

1

: 1.Lt empyema.

2.Pneumonia.

: Decortication via VATS(Video

assistedthoracoscopic surgery)

0BDP4ZZ

1

2

2

:

1.Pneumothorax. J93.11

2.Goiter. E04.9

:

1.Wedge resection of RUL and RLL via VAT

2.Mechenical pleurodesis

2

1.Wedge resection of RUL and RLL via VAT

2

2.Mechenical pleurodesis

Right

pleura

2

3

:

1.Pneumonia. J18.9

2.Acute repiratory failure. J96.00

:

Tracheostomy

0B110F4

3

4

4

5

Chronic rhinitis with nasal septum deviation

H/T

DM

Septomeatoplsty

J31.0

J34.2

I10

E11.9

Nasal

septum

Nasal

turbinate

09BM4ZZ

Excision of Nasal Septum,

Percutaneous Endoscopic

Approach

09BL4ZZ

Excision of Nasal Turbinate,

Percutaneous Endoscopic

Approach

5

Bilateral septomeatoplasty 002169

Septomeatoplasty 09BM0ZZ ()+ 095L7ZZ()

1.(2014 coding Handbook 240) 2. SMT()excision SMR()repositionexcision(Killian incision)

1 Right empyema with lung abscess

thoracoscopic decortication of pleural peel and lung abscess incision 0BDN4ZZ+0B9F4ZZ

Empyema J86Tabular list Excludes1:abscess of lung (J85.-)

empyema with lung abscess

J85.2+J86.9J85.2

nil right chest pain for days Right empyema with lung abscess thoracoscopic decortication of pleural peel and lung abscess incision(Finding:Loculated effusion about 200 cc, turbid yellowish, with fibrin tissue

and pleural peel formation of RLL. Adhesion of Rt lung to chest wall, diaphragm

and mediastinum. Abscess formation of RLL noted.)

/nil

1.exclude1:

2.F45.8 Other somatoformexclude1:G47.63(Sleep related teeth grinding)F45.8 (psychogenic dysmenorrhea)G47.63(Sleep related teeth grinding)F45.8+G47.63

2016 coding clinic 4th

Lt tympanoplasty (type III, PORP 2.0, tragal cartilage, areolar

graft)+ atticoplasty + atticotomy + ossiculoplasty

Rttympanoplastytype III +meatoplasty

2

WORD

1.(myringoplasty)(areolar tissue)[1]

2.(Mastoidectomy)

3. -

middle ear tympanic cavity aditusantrumepitympanum (attichypotympanum6mm2mm4mm

LT tympanoplasty typeIII:exsion of temporalis fascia

QA:2082(Harvest: Areolar tissue graft)temporalis fascia()? temporalis muscle

LT tympanoplasty typeIII:exsion of tragal cartilage

LT tympanoplasty typeIII: myringoplasty

QA:2082Tympanoplasty typeI(typeIII)

LT tympanoplasty typeIII:ossiculoplasty

PORP 2.0

Tragal cartilage

LT tympanoplasty typeIII:mastoidectomy

QA:2235

att