Deconditioning: A Case Study

HEENT: No thyroid enlargement, masses or adenopathy, JVP was 5 cm above sternal Angle, carotid pulse was strong and regular

Part 1: Discuss the necessity of understanding the interaction of the CPT procedural codes and the ICD diagnostic codes.

Mr. Henry and his wife need medical care coordinated throughout the health care system to receive proper treatment and prevent health complications, encouraging their independence by remaining in the same setting. Marek and Rantz highlight that by providing care coordination and health care services for older adults residing in specially designed senior apartments, older adults will not have to move from one level of care delivery to another as their health care needs increase; and they will have the opportunity to “age in place” (Marek & Rantz, 2000). Care coordination starts with a comprehensive assessment of each of Henry and Ertha individual needs for health and social support, and by developing an individualized plan of care for each of them. “Patients should be evaluated, and care plans should be designed and implemented according to the individual needs of each patient (American Geriatrics Society, 2012, p. 1966). As Mr. Henry and his wife health care needs increase, they can receive periodical physical examinations to monitor their underlying health problems, and for early detection of complications remaining in their apartment. This will prevent negative outcomes associated with relocation, and medications and treatment noncompliance.

➤ Diagnosis classification system developed by the Centers for Disease Control and Prevention for use in all U.S. health care treatment settings. Diagnosis coding under this system uses 3–7 alpha and numeric digits and full code titles, but the format is very much the same as ICD-9-CM

17. The correct codes for this case are CPT codes 13121, 13160. The ICD-9 code is 998.31.

The implications and effects on patients waiting long hours to be seen in the ED are immense. In a recent study done over five years in Ontario hospitals showed the risk of adverse events and even deaths increased with the length of stay in the ED (Science Daily, 2011). When EDs become overcrowded the quality of care changes and declines; which is extremely dangerous. Authors of the study calculated that if ED length of stay was cut by only an hour that 150 fewer Ontarians would die each year (Science Daily, 2011). Wait times can also negatively affect patients financially, untreated medical conditions can lead to reduced productivity and inability to work leading to increased financial strains (Fraser Institute, 2014). As well as delayed access to care can result in more complex interventions needed. Therefore an initiative is needed to provide patients with timely, efficient care when accessing

The International Classification of Diseases, Tenth Revision (ICD-10) has been in development since 1983 to replace the outdated Ninth Revision (ICD-9) that has been in use in the U.S. for over 35 years (Giannangelo, 2015). Due to the Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification regulation published in 2009, the Clinical Modification (ICD-10-CM) will replace ICD-9-CM Volumes 1 and 2, and the Procedure Coding System (ICD-10-PCS) will replace ICD-9-CM Volume 3 for all HIPAA transactions effective October 2015 (Giannangelo, 2015). These new code sets accommodate new procedures and diagnoses and allow for greater specificity in clinical documentation (Centers for Medicare & Medicaid Services [CMS],

O: No impairment noted, VSS, in no acute distress, no redness, edema, or warmth noted to hands, wrists, and knees. FFD

The human species of the world are growing older, and existing longer. Research shows that the average life expectancy of humans living past the age of 80, since the 1800s to that of 2011, has increased by almost 10% per year, with women leading the way with a growth expectancy growing from that of 6.4% to that of 9.6%, surpassing their male counterpart whose life expectancy show an increase from 5.9% to that of 8.2%. As the human life expectancy increases, there also comes an increase concerns by individuals and government official alike in regards to elder care. This literature looks at what is being carried out by individuals as well as government officials to deal with the cost of living longer. We will examination approaches identified

I have always believed that the elderly do very little with their time. I found a positive aspect about the elderly - even though they are old, the patients were creatively active by own choice which makes them busy and so they have happy existence. In the low care unit people were doing recreational work such as painting and stick picture and cartoon on the paper. I found health professionals were polite and friendly with the patients. I also found patience in the staff and the patient when they are communicating with each other. The health professionals encourage patients to speak and genuinely interested in client’s word and encourage them to converse. This interaction impressed me a lot and I learned a new lesson how to motivate people.

Healthcare in the United States is changing which has given rise to new hurdles that must be overcome. One of the issues that we are currently facing in many tertiary facilities is the need for set criteria involving intensive care unit admissions and discharges. Throughout the country the total number of intensive care unit (ICU) beds are on the rise, but the current supply still outnumbers the demand (Cognet & Coyer, 2014). The cost of staying in an ICU is continuing to increase with technology, and there are limitations that insurance companies and the government have set forth to the number of days a patient can reside there dependent upon his diagnosis and condition. Intensive care units will continue to undergo strain due to high census, and decisions to discharge patients will be effected (Wagner, Gabler, Ratcliffe, Brown, Strom, & Halpern, 2013). Typically, the decision to have a patient occupy an ICU bed is based upon whether or not they are sick enough to be there or if they are well enough to be discharged to a progressive care unit (PCU) or medical surgical unit (Meyer, 2003). A progressive care unit is a step down from an ICU, but has stricter criteria for admission than a medical surgical unit based upon the patients medical status. Not all facilities offer a PCU, but the need for this level of care is continuing to rise with the number of ICU admissions increasing. Standardized guidelines for patient placement in

Aiken, L.H., Clarke, S.P., Sloane, D.M., Lake, E.T. & Cheney, T. (2008). Effects of hospital care

Taking care of the individuals that are getting older takes many different needs. Most of these needs cannot be given from the help of a family. This causes the need of having to put your love one into a home and causing for the worry of how they will be treated. It is important for the family and also the soon to be client to feel at home in their new environment. This has been an issue with the care being provided for each individual, which has lead to the need of making sure individuals have their own health care plan.

By 2036, nearly one in four Canadians will be a senior” (Stastics Canada, 2014, Demographics section, para. 3). There are widespread implications on the healthcare system, the economy, and society as a whole as “Canada’s median age is the oldest it’s ever been – 40.5 years old” (Paperny, 2015, para 2). “While Canadians older than age 65 account for less than 15 per cent of the population, they consume 45 per cent of provincial and territorial government health care dollars” (Canadian Institute for Health Information (CIHI), 2014, p. 16). One of the most important issues for our aging population is the lack of home care in our current society. We cannot simply create more homecare, there are “complex webs and loops of cause and effect with the inherent potential for unpredictable and far-reaching consequences” (Van Beurden, Kia, Zask, Dietrich, & Rose, 2011, p. 74). We must first determine if it is necessary, then consider funding, staffing, resource allocation, implications on individual wellbeing, and long term effectiveness among other

Our elderly population is living longer than ever before and not all of them are entering into a nursing home. They are choosing to stay in their own home or their caregiver is choosing it for them. Some caregivers are choosing to move their ageing love one in the home with them. Whatever the case may be, there is an increased need for some type of home health as it applies to the elderly population. “Medicare will pay the full cost of professional help only if the physician