1) patient came to the er complaining of chest pain. ekg and labs including troponin levels were performed. Nitroglycerin was administered and oxgyen therapy initiated. Results of the tests indicated the patient was having an anterior wall myocardial infarction. patient was taken to the cath lab for immediate single vessel angioplasty. following the percutaneous coronary intervention, the patient was admitted to the floor. he was monitored continuously. beta blockers and coumadin therapy were begun. the patient's hypertension was addressed, and he received medication for low potassium levels as well. his diabetes was managed by medication and diet with no significant issues during the admission. after four days the patient was discharged home to continue his medication regime and begin cardiac rehab.

Codes assigned by student:

R07.9

i10

E87.6

i21.09

E11.9

02703ZZ

2) Watch the video "99 Differentials."...

Watch the video "99 Differentials." https://www.youtube.com/watch?v=TnkvLtJitvA and answer the following:

1. Identify the medical content mentioned in the video
2. Determine which clinical terminologies, classifications, and code systems would be used to capture the content and describe their findings

3) A family of five is covered by multiple insurance companies: Father Jones works for a private firm, has his primary health insurance (ABC) through work, and secondary health insurance (XYZ) through his wife. Mother Jones works for the state the Jones family resides in, has health insurance through work, and life insurance through her husband. Sally Smith is covered under her mother's health insurance policy until the age of 24. Jeff Jones works at a bookstore and is covered under his father's life insurance policy. Nikki Jones is covered under both of her father and mother's policies Determine the coordination of benefits for each family member for the visits listed in the table below. The first visit is completed as an example: Father Jones has the flu and goes to the doctor. Primary insurance is ABC and secondary is XYZ because his insurance is primary for his visits.

4) A 72-year-old female was admitted from skilled nursing with complaints of right flank pain and fever.

1. Principal diagnosis - Kidney stone
2. Secondary diagnoses - Urinary tract infection, nos, N39.0, streptococcal B cause of disease B95.1, Hypertension I10, and Chronic kidney disease N18.9

MS-DRG______________________

1. A 78-year old female is discharge home with the following diagnoses:
   1. Principal diagnosis - acute systolic, CHF
   2. Secondary diagnoses -Lupus (SLE), Insulin-dependent diabetes uncontrolled ( M32.9, E10.65)

MS-DRG_______________________

1. If the same patient from Question 2 also had a diagnosis of an acute exacerbation of COPD, what is the MS-DRG?

MS-DRG______________________

1. If the patient from Question 2 also had a diagnosis of gram negative pneumonia, what is the MS-DRG?

MS-DRG _____________________

Provide the CPT codes that should be assigned to the cases below along with their corresponding APC.

1. A 75-year-old male has an ESWL performed for a right renal calculus. At the same operative session, the same physician removes a malignant lesion from his back resulting in a 3 cm. defect and performs an intermediate repair.

5) The claim for S. Smith, a 10-year-old that had a tonsillectomy on

May 8, 2019, was billed with the following information on May 12, 2019: S. Smith 123 New Road Bridgeville, OH 44556 DOB 6/12/1950 CPT code 42825 1 Claim adjustment reason code (CARC) 6 returned on the remittance advice to indicate the procedure was not paid. 2 Determine the issue that the CARC identifies and what steps must be taken to correct it.

6) Identify the federal regulation or initiative used to combat fraud and abuse described in the following table.