CASE STUDIES IN HEALTH INFORMATION MANAGEMENT 81 CASE 2-26 Medicare-Severity Dia

Question

CASE STUDIES IN HEALTH INFORMATION MANAGEMENT 81 CASE 2-26 Medicare-Severity Diagnosis-Related Group (MS-DRG) Changes You just received a MS-DR: change leter from the QTO. Ihe medical record shows that the patient admitted to the hospital with a high fever and difficultly breathing. A chest x-ray was taker no signs of pncumonia White blood cell coun (WBC) was 17.4, blood cultures grew arterial blood gases (ABGs) CO2 rate was 49.6; and the O, rate was 53.2. The patiet was with ad sowed curdomonas diagnosed septiccnia and new-onse asihma. he patient was treated with intravenous (IV) antibiotics, respira- tory therapy, and bronchodilators. Since both of the diagnoscs met the delinition of principal diagmosis the coder chose septicemia as the principal diagnosis since it paid more money. The MS-DRG chauge notice said that the principal diagnosis should have been asthma Write a letter to suppot your choicc of principal diagnosis

Explanation / Answer

I support it will be a bronchial asthma induced by pseudomonas.Blood culture shows the growth of organism.It cause the WBC to increase in case of inflammation especially esinophills.Patient have bronchial inflammation hence have breathing difficulty. ABG support the dyspnea by low oxygen level.Chest x-ray not shows much effect because the affect still not reaches the lung.Infection cause fever and bronchial inflammation cause breathing difficulty. By the investigation mentioned above I strongly support it is new- onset asthma.

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