Medical Coding Discussion

Part A: Answer each of the following questions in one or two paragraphs.

Code the following operative report.

Preoperative Diagnosis: Left flank soft tissue mass

Postoperative Diagnosis: Left flank soft tissues mass

Surgeon: John Doe, DO

Operations: Excision of left flank soft tissue mass with layered closure measuring 4 cm, with margins, prior to excision

Anesthesia: sedation with 1% lidocaine with epinephrine and sodium bicarbonate Operative Indications: this is a pleasant female who comes in with soft tissue lesion in the left flank over what appeared to be a Spigelian Hernia site as well. However, it was not reducible and did not appear to be consistent with a hernia. 

Consequently, the procedure, risk, benefits, and alternative of excision of this lesion were discussed with the patient, and she understood and wished to proceed with the excision. Operative Findings: Large soft tissue lesion measuring about 6 cm in greatest dimension

Operative procedure: The patient was brought into the operating room after informed consent was obtained. The patient then underwent sedation with a sterile prep and drape. We then anesthetized with 1% lidocaine with epinephrine and sodium bicarbonate, made a 4-cm incision, and used sharp dissection to dissect circumferentially around this soft tissue lesion, being careful to make sure that we were not entering any kind of hernia sac secondary to Spigelian hernia. 

As we continued to dissect circumferentially around it without sharp dissection, it was noted that it did go down to a muscle, but no evidence of hernia was identified. The lesion was excised in its entirety and electrocautery was used to control hemostasis. We then irrigated with saline solution and closed the subcutaneous tissue with 3-0 Vicryl interrupted and sutures. 

We then used 4-0 Vicryl sutures to close the skin in a subcuticular fashion. Benzoin and Steri-Strips were then applied. Blood loss was minimal. The patient tolerated the procedure well and remained in stable condition throughout the procedure.



Discuss two differences between inpatient and outpatient coding. Discuss coding for obstetrics in relation to the global fee for antepartum and postpartum periods of a normal pregnancy.

Part B. Answer each of the questions in one to four sentences.

What is the difference between Excludes1 and Excludes2 notes in the ICD-10? As a hospital outpatient coder, how would you explain evaluation and management to a health information technology intern? What are the three type of wound repair, and what must be documented to code them? How do the types of immunization differ? 

A patient with a pre existing diagnosis of congestive heart failure was seen in the emergency room for treatment of pneumonia and admitted to the hospital where they discovered the patient was again in congestive heart failure. What guidelines apply to coding these diagnoses, which one would be the principal diagnosis, and why? General Anesthesia is provided for a patient undergoing an upper gastrointestinal endoscopy. 

Discuss why Current Procedural Terminology codes are used for anesthesia. Who assigns an anesthesia code? What guidelines apply to coding these diagnoses, which one would be the principal diagnosis, and why? A patient has a five-year history of diabetes mellitus. The patient is admitted to the hospital due to insulin pump malfunction. 

Discuss the ICD-10-CM coding guidelines for underdosing and overdosing of insulin due to insulin pump malfunction. What are some of the problems associated with modifiers- 51 and -59? Explain how evaluation and management (E/M Codes are grouped. A 10-year-old patient is admitted for multiple injuries after being hit by a car while riding his bike.

Discuss the coding guidelines for reporting injuries.

Reimbursement Methodologies


Explain the four applications of modifier- 51. Explain the difference between fraud and abuse with respect to medical billing practices. Discuss specific regulations about workers’ compensation medical records.

Part B. Answer each of the following questions in one to five sentences. Describe the characteristics of a centralized billing office (cbo). Describe the three categories of cpt codes. Explain the coordination of benefits (cob) provision in a managed care contract. How should a medical office specialist use volumes 1 and 2 of the icd-90-cm book? 

What is an inpatient? What facility handles the hospitals’ claims and accounts receivable for a state or region? What is physician self-referral as regulated by the stark law? What do the terms upcoded and downcoded mean? What form do physicians use to bill insurance carriers? What is the computer system that includes information on procedures, services, charges, and revenue of inpatients called?

Essential of Psychology

Part A: Select One of the following questions to answer in one or two paragraphs. Outline Freud’s structural model of the psyche. What are its three main parts? How are they related? Roughly, how much of our psyche is unconscious? In the context of your discussion, explain the meaning of sublimation. Discuss the different kinds of parenting styles, Provide examples, Outline the effects parenting styles have on children, Finally, what role does temperament play in assessing the relative merits of parenting styles?

Part B Answer each of the following In three to five sentences.

In brief, what is the primary thesis of the James-Lange theory of emotion? In an experiment studying the effects of background-noise levels on reading- content retention, what would you assume to be the dependent variable? What would you assume to be the independent variable why? What kind of drug is Rohypnol, and why is called the ‘’ date rape drug’’? What is the reticular formation? 

Where are we located, why is it important? Discuss memory traces and their role in decay. When you wish an employee to become adept at a particularly boring task, which schedules of reinforcement would you choose? Why? Discuss the term cognitive dissonance and how it helps people continue with dangerous habits. Define prejudice, stereotype, discrimination and self-fulfilling prophecy. How are they all related? Discuss the importance of REM sleep. Contrast the medical, psychoanalytical, behavioral, cognitive, humanistic, and sociocultural perspectives of mental illness.

Part C:

In a case of __________, perhaps due to a severe psychological trauma, a person, a person’s memories are repressed, even to the extent that he may not remember his name. Dissociative fugue Dissociative fugue Dissociative Amnesia Dissociative identity disorder Intrinsic and extrinsic form dog motivation are both considered in the_____________ perspective on motivation. Hierarchical Drive- Reduction Incentive

Cognitive: The so-called foot-in-the-door technique illustrates Obedience. Compliance. Conformity. Resistance. Also referred to as the ‘’ master gland, ‘’ the ______ gland controls the functioning of the overall endocrine system. Pituitary Thyroid Steroid.