Question

The patient is a 55-year-old male who is brought to the emergency room by his family. Tell the physician that over the past two weeks the patient has had difficulty walking to int that today, he cannot walk at all. The emergency physician identifies the problem progressive ataxia and starts to investigate the cause. The patient states his legs do not hurt will he feels his legs are weak and cannot support him. The patient had a 40-year history of abusing alcohol and admits he is an alcoholic. He also admits to smoking a pack of cigarettes per day for the same amount of time. The physician concludes there are no other medical problems such as pancreatitis or cirrhosis of the liver as a result of the alcohol dependence. The patient was admitted to the hospital with the admitting diagnosis of ataxia. The attending physician and neurology consultant speculate the ataxia was cerebellar from alcoholic degen- eration of the cerebellum or possibly Wernicke's encephalopathy. Over the next 24 hours, the patient became very confused and agitated with some violent outbursts and actions. After a couple days of confusion and disorientation, the patient's sensorium slowly cleared. The physicians considered whether the patient was experiencing delirium tremens, but his fam- ily said the patient had been sober for the two weeks prior to admission: his ataxia seriously concerned him, so he stopped drinking. The patient had several abnormalities in his labora- tory tests, including a severe thiamine deficiency that could be causing the encephalopathy. The pulmonary medicine physician examined the patient and concluded his chronic cough was due to chronic bronchitis/COPD. Because the neurologist was looking for evidence of Wernicke's encephalopathy, an MRI of the brain was performed and showed the cerebellum as normal in size and shape, but a CT of the brain showed an area of calcification in the right occipital region. Over the next 5 days, the patient's ataxia lessened and the patient was able to ambulate slowly with a walker and physical therapy. It was also determined the patient had essential hypertension and was started on antihypertensive medications. The patient was discharged with medications prescribed including antihypertensive oral medicine, folic acid, and multivitamins as well as an inhaler to treat the chronic bronchitis. The patient was encouraged to maintain his sobriety by joining the local Alcoholics Anonymous organization and to discontinue smoking. The discharge diagnoses documented were possible Wernicke's chicephalopathy, chronic alcohol dependence, nicotine dependence, COPD/chronic bronchitis. and hypertension. Principal Diagnosis: Secondary Diagnoses:

please provide ICD-10-CM codes

Answer 1

ANSWER-  

• A00.0 - B99.9 1.certain infectious and parasitic diseases(A00 - B99)
• C00.0 - D49.9 2. Neoplasms ( C00 - D49)
• D50.0 - D89.9 3. Diseases of the blood and blood forming organs and certain disorders involving the immune mechanism. (D50 - D89)
• E00.0 - E89.89 4.Endocrine, nutritional and metabolic disease (E00 - E89)
• F01.50 - F99 5.Mental , behavioral and neurodevelopmental disorders (F01 - F99)
• G00.0 - G99.8 6. Disease of nervous system(G00- G99)
• H00.011 - H59.89 7. Disease of eye and adnexa(H00-H59)
• H60.00 - H95.89 8. Disease of the ear and mastoid process (H60- H95)
• I00 - I99.9 9.Disease of circulatory system.(I99 - I99)
• J00 - J99 10. Disease of respiratory system (J00 - J99)
• K00.0 - K95.89 11. Disease of digestive system (K00 - K95)
• L00 - L99 12. Disease of skin and subcutaneous tissue (L00 - L99)
• M00.00 - M99.9 13. Disease of musculoskeletal system and connective tissue (M00 - M99)
• N00.0 - N99.89 14. Disease of genitourinary system ( N00 - N99)
• O00.0 - O9A.53 15. Pregnancy childbirth and the puerperium ( O00 - O9A)
• P00.0 - P96.9 16.Certain conditions originating in the perinatal period( P00 -P96)
• Q00.0 - Q99.9 17. Congenital malformations and chromosomal Abnormalities( Q00 - Q99)
• R00.0 - R 99 18. Symptoms , signs and abnormal clinical and laboratory findings (R00 - R99)
• S00.00XA - T88.9XXS 19.Injury, poisoining and certain other consequences of external cause(S00 - T88)
• V00.01XA - Y99.9 20. External cause of morbidity ( V00 - Y99)
• Z00.0 - Z99.89 21. Factors influencing health status and contact with health services (Z00 - Z99)