Hi All, so I got a B- on the below case. sigh* sigh* 
Any dispute on the coding given?
DOA- 18/1/2013
DOD – 26/1/2013
Discharge diagnosis Anemia of chronic disease
1. Chronic renal insufficiency
2. Diabetes mellitus, insulin dependent
3. Hypertension
4. Coronary artery disease
5. Congestive heart failure
6. Hypokalemia
Attending Physician for service: Family practice service
Consultations: None
Procedures: None
Hospital Course: The patient is a 66 year old gentle man with multiple medical problems including coronary artery disease, insulin dependent diabetes mellitus and chronic renal insufficiency, who presented to the emergency department at Anytown hospital on 18/1/2013 complaining of shortness of breath. He had been seen in the office earlier that week and seemed to be doing reasonably well at that point in time.
On admission he said that over last two three days his shortness of breath had been increasing and he had orthopnea and a nonproductive cough. He denied chest pain at that point of time. He denied other symptomology.
In the emergency department he was noted to have significant anemia with hemoglobin of 7.0 and a hematocrit of 21.2 with an MCV of 78.3. He was given two units of packed red blood cells via peripheral vein and admitted to the transitional are unit to rule out myocardial infarction and to receive blood.
Answer from Lecturer:
Anemia is the primary condition treated, hence to be sequenced first, since the underlying cause of anemia is unknown query the doctor,
• I12.9 - Hypertension, kidney
• N18.9 - Renal chronic insufficiency
• E11.9- Diabetese Type II
• Z79.4 - Long term drug therapy, insulin
• I25.10 - Arteriosclerosis, coronary artery
• I50.9 -Congestive heart failure
• E87.6 – Hypokalemia
Any dispute on the coding given?DOA- 18/1/2013
DOD – 26/1/2013
Discharge diagnosis Anemia of chronic disease
1. Chronic renal insufficiency
2. Diabetes mellitus, insulin dependent
3. Hypertension
4. Coronary artery disease
5. Congestive heart failure
6. Hypokalemia
Attending Physician for service: Family practice service
Consultations: None
Procedures: None
Hospital Course: The patient is a 66 year old gentle man with multiple medical problems including coronary artery disease, insulin dependent diabetes mellitus and chronic renal insufficiency, who presented to the emergency department at Anytown hospital on 18/1/2013 complaining of shortness of breath. He had been seen in the office earlier that week and seemed to be doing reasonably well at that point in time.
On admission he said that over last two three days his shortness of breath had been increasing and he had orthopnea and a nonproductive cough. He denied chest pain at that point of time. He denied other symptomology.
In the emergency department he was noted to have significant anemia with hemoglobin of 7.0 and a hematocrit of 21.2 with an MCV of 78.3. He was given two units of packed red blood cells via peripheral vein and admitted to the transitional are unit to rule out myocardial infarction and to receive blood.
Answer from Lecturer:
Anemia is the primary condition treated, hence to be sequenced first, since the underlying cause of anemia is unknown query the doctor,
• I12.9 - Hypertension, kidney
• N18.9 - Renal chronic insufficiency
• E11.9- Diabetese Type II
• Z79.4 - Long term drug therapy, insulin
• I25.10 - Arteriosclerosis, coronary artery
• I50.9 -Congestive heart failure
• E87.6 – Hypokalemia