ICD10 Coding Annual Physical with Chronic Conditions
Laureen Q Annual Physical ICD10 question, if a patient is in for an annual physical and has chronic conditions like diabetes mellitus or hypertension, would you use Z00.01 Alicia Chandra knows this one. Chandra A Z00.01 is annual preventive or adult preventive examination with abnormal findings. As we talked about earlier, abnormal findings means we found something during that exam that we didn't already know that the patient had. Chronic conditions would be things we already knew the patient had. The thing that I go back to with that and then determining whether we knew it ahead.
Of time, look at some of your documentation guidelines. If you really want to think about it, I'm going to cite inpatient for a minute, but if you look at your Present on Admission Guidelines, they tell you any chronic condition that patient had before they were admitted are considered present on admission. It's kind of the same thought, they come in and do a preventive exam, we knew they had hypertension, we knew they had diabetes, we knew they had whatever. Even if we write them a script to refill those meds, it's not that we found something abnormal.
During this exam. It's simply that we gave them a script for their chronic conditions. Laureen Very good. Alicia If it is a new condition, they'll document that they'll be doing counseling on they're sending them to the diabetes nurse and getting counseling on nutrition that this is a new finding but Chandra And then in that case, then they also have to make sure that anytime they use the code that says they did a preventive with an abnormal finding they need an additional code to identify what that abnormal finding is. That's typically where they're going.
PMS and Estrogen Dominance
We are starting to get more and more women that are bringing their daughters now. It's so good to seeit's preventive medicine. The first thing the mother says is, They're terrible around their PMS symptoms, and their breasts are hurting them, and they're very irritable and it's just very difficult to be around my young girl at this time. So they bring them in and we do a salivary hormone test, check their estrogen, progesterone, testosterone, and DHEA, because we also want to rule out stuff like PCOS and such as this.
But we, uh this is an indication that most of the time we see a low progesterone and what we do is we either give them botanicals or we give them a little bit of progesterone cream and it works wonders. I much prefer to use bioidentical estrogen and progesterone when I have to and I don't use the synthetic. So all that said, the estrogen dominance is big in the United States. The girls are coming inmothers bringing the girls in so we can check that at an earlier age, it's great to see that, it's a preventative, less girls on.
Fibroid Facts Where do fibroids grow
Hey there new channel, new news. I wanted to talk about an issue that is really close to my heart. Fibroids. So it's a new channel called Fibroid Nutrition. There is a lot of information out there I've found and I want to share it. Basically what are fibroids, fibroids are muscle tissue that are tumors but they are non cancerous and they grow inside and outside of our uterus. So if we look at our uterus like this SHOWSHANDS they grow in between my fingers, in between my fingers, and on the outside of my fingers.
They have stems, they can, if they grow on the outside they can have a stem and they can grwo and then they can cause pain and discomfort yk in other locations in your body. So yk they can cause a lot of problems like excess bleeding um, pain, pain during sex, a lot of different things. yk I'm sure you all have either have them, know about them or know someone who has them and there is something that you can do. and basically this channel is yk just so that your uterus is not a casualty. so hopefully you'll stick.
How to Read a MRI of Lumbar Degenerative Spondylolisthesis and Spinal Stenosis
Here's a side view of an MRI of a patient with substantial degenerative changes and a degenerative Spondylolisthesis Stenosis or slip at four five and the central canal is also blocked and that is called spinal stenosis again reading this MRI we see the spinal cord here which ends there and the nerve roots which come out of the spinal cord again the white is cerebral spinal fluid which is water we see again the vertebra we see again the discs these discs here are quite degenerative and if we look carefully we're going to see that this L four vertebra has slid.
Forward on L five that slip is called a degenerative Spondylolisthesis and we can look at the spinal canal and see the spinal canal in this area his clogged up essentially and quite narrowed and that is deleterious to the nerves we can look at this with a topdown view and again the yellow line here is where we're making our cut here's the spinal canal we can see all of the nerve roots here we look at the facets before these are degenerative facets and if we march up the spine and watch the size of the canal.
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