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ICD-10 Coding Training and Certification

2010-12-20T14:51:00Z

Welcome to nation’s leading organization for ICD-10 Implementation

ICD-10 Coders Academy is dedicated to helping providers, facilities and payers smoothly transition into the use of ICD-10 in their practices. With standards that embody our commitment to good practices and industry-recognized credentials that reflect our staff’s expertise in ICD-10 implementation, you are assured of an easy transition for your practice. ICD-10 Coders Academy is committed to equipping our members with foresight into the implementation process of ICD-10. Our goal is to prepare our members thoroughly for all potential ICD–10 transition challenges and to provide continuous professional development for them.

In order to support our mission of making ICD-10 implementation easy for everyone, ICD-10 Coders Academy is offering certifications, ICD-10 code translators, customized ICD-10 coding tools, EMR/EHR interoperability testing services, etc. We have also developed the nation’s first comprehensive ICD-10 coding tool, ICD10 MadeEasy.

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Schizophrenia Homeo Cure

2010-12-20T14:47:00Z

Schizophrenia is a heterogeneous syndrome characterized by perturbations of language, perception, thinking, social activity, affect, and volition.

Epidemiology

Epidemiologic surveys identify several risk factors for schizophrenia including

1. Genetic susceptibility

2. Early developmental insults

3. Winter birth

4. Increasing parental age.

5. Genetic factors are involved in at least a subset of individuals who develop schizophrenia.

Pathophysiology

A number of structural and functional abnormalities have been identified in schizophrenia, including

(1) cortical atrophy and ventricular enlargement

(2) specific volume losses in the amygdala, hippocampus, right prefrontal cortex, fusiform gyrus, and thalamus

(3) progressive reduction in cortical volume over time

(4) reduced metabolism in the thalamus and prefrontal cortex

(5) abnormalities of the planum temporale

(6) changes in the size, orientation, and density of cells in the hippocampus and prefrontal cortex, and decreased numbers of cortical interneurons.

Clinical Manifestations

There are no pathognomonic features. The syndrome commonly begins in late adolescence, has an insidious onset, and, often, a poor outcome, progressing from social withdrawal and perceptual distortions to recurrent delusions and hallucinations.

Patients may present with positive symptoms such as

Conceptual disorganization

Delusions

Hallucinations

Negative symptoms

Loss of function

Anhedonia

Decreased emotional expression

Impaired concentration

Diminished social engagement

The patient must have at least two of these for a 1-month period and continuous signs for at least 6 months to meet formal diagnostic criteria.

As individuals age, positive psychotic symptoms tend to attenuate and some measure of social and occupational function may be regained.

Negative symptoms predominate in one-third of the schizophrenic population and are associated with a poor long-term outcome and a poor response to drug treatment. However, marked variability in the course and individual character of symptoms is typical.

CLASSIFICATION:

The four main subtypes of schizophrenia are

Catatonic: Catatonic-type describes patients whose clinical presentation is dominated by profound changes in motor activity, negativism, and echolalia or echopraxia.

Paranoid: Paranoid-type describes patients who have a prominent preoccupation with a specific delusional system and who otherwise do not qualify as having disorganized-type disease, in which disorganized speech and behavior are accompanied by a superficial or silly affect.

Disorganized: schizophreniform disorder describes patients who meet the symptom requirements but not the duration requirements for schizophrenia, and schizoaffective disorder is used for those who manifest symptoms of schizophrenia and independent periods of mood disturbance.

Residual: In residual-type disease, negative symptomatology exists in the absence of delusions, hallucinations, or motor disturbance.

Many individuals have symptoms of more than one type.

The term Prognosis depends not on symptom severity but on the response to antipsychotic medication.

Schizophrenia-prone families are also at risk for other psychiatric disorders, including schizo affective disorder and schizo typal and schizoid personality disorders, the latter terms designating individuals who show a lifetime pattern of social and interpersonal deficits characterized by an inability to form close interpersonal relationships, eccentric behavior, and mild perceptual distortions.

Despite evidence for a genetic causation, the results of molecular genetic linkage studies in schizophrenia are inconclusive. Major gene effects appear unlikely.

Differential Diagnosis

The diagnosis is principally one of exclusion, requiring the absence of significant

· Associated mood symptoms

· Relevant medical condition

· Substance abuse.

· Drug reactions that cause hallucinations, paranoia, confusion, or bizarre behavior may be dose-related or idiosyncratic

· Parkinsonian medications

· Drug causes should be ruled out in any case of newly emergent psychosis.

THERAPEUTICS:

HYOSCYAMUS:

Remedy for acute mania with extreme excitation of sensorium and abnormal impulses

The patient imagines that he is pursued by some demon or that some one is trying to take his life and he runs away from an imaginary foe

He is talkative and constantly jumps from one subject to the other

COCAINE:

This remedy has the sensation as if foreign bodies were under skin and this is a hallucination

It has also hallucinations of hearing

STROMONIUM:

The remedy has most wild and terrifying mania

It has full of hallucinations he sees rats ,mice, snakes, and other animals approaching him and he retires in terror

He is loquacious and becomes religious and out bursts in violence with ideas of persecution

AURUM MET:

One of the great remedy for melancholia where there is an actual disgust for life

There is longing for death and tendency to suicide

This tendency is only mental and the patient rarely attempts it

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Neoplasm Medical Coding

2009-09-19T16:18:00Z

NEOPLASM:-

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Neoplasms may be benign (not cancer), or malignant (cancer). Also called tumor

Neo means new and plasm means growth. Neoplasm is a type of cancer. Cancer of 2 types benign and malignant.

Benign:- Tumor that doesn’t spread and can be cured by excision {surgical removal}

Malignant:- Tumor that spread, there will be continuous growth and difficulty to cure. The spreading of tumor is known as metastasis. It spread through blood and lymph fluid.

Coding Rules:-

1^st indentified the behavior.

2^nd locate the site.

Neoplasm behavior:- ICD-9-CM classifies malignant neoplasm as primary, secondary and carcinoma in situ.

Primary:- identifies the site{location} of origin of the neoplasm. Determination of patient’s origin and type of cells is important to find the severity of illness and planning treatment.

Secondary:- indentifies the site to which the primary site has spread by direct extension to surrounding tissues.

Carcinoma in situ:- it doesn’t spread beyond the point of origin { it’s a tumor cells which are undergoing malignant changes, these changes don’t extend}

Uncertain behavior:- not yet tested. {tumors which show features of both benign and malignant behavior.

Metastatic from and of :- site is primary

Metastatic to:- site is secondary

Assign the code 199.1 when secondary site is not mentioned.

For examples:-

Metastatic carcinoma to the liver

Px: primary site Sx: secondary site

Code: Px: 199.1 Sx: 197.7

Metastatic carcinoma of the pancreas

Code: Px: 157.9 Sx: 199.1

Metastatic carcinoma from the breast

Code: Px: 174.9 Sx: 199.1

Metastatic carcinoma of brain and lung

Code brain and lung as secondary site, assign the code 199.1 as primary site is not specified.

Codes:- Px: 199.1

Sx 1: 198.3 {brain}

Sx 2: 197.0 {lung}

Metastatic renal cell carcinoma of the lung

Code first primary site as renal cell carcinoma then code Secondary site as lung.

Codes: Px: 189.0 {renal cell}

Sx: 197.0 {lung}

Carcinoma of the oral cavity and pharynx

Notes: when the patient of origin can’t be determined because the neoplasm overlaps the boundaries of 2 or more contiguous [adjacent] site, it’s classified to 4^th digit “8”

Code: 149.8 [Malignant neoplasm of lip, oral cavity and pharynx whose point of origin can’t be assigned to any one of the categories.]

Metastatic carcinoma of retroperitoneum and peritoneum

Code: Px: 199.1

Sx: 197.6 [retro+ peritoneum code only once]

Metastatic carcinoma of the ovary

Code: Px: 183.0

Sx; 199.1

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2009-09-18T15:48:11Z

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