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1.   Anesthesia administered to a normal, healthy patient undergoing an esophageal procedure is coded as

A. 00500-P1.   B. 00502-P1.   C. 00500-P2.   D. 00506-P1.

 

2.   A new patient comes into the doctor’s office for her annual gynecological exam. During the course of the exam, she undergoes a screening cervical cytopathology smear, which is performed by an automated system under the supervision of a physician. What HCPCS code is assigned?

A. G0185   B. G7869   C. G7452   D. G0147

 

3.   A new patient is seen for a home visit that involves a comprehensive history, examination, and medical decision making of high complexity. What code should be assigned?

A. 99349   B. 99345   C. 99342   D. 99350

 

4.   A prolonged evaluation and management service before and/or after direct patient care for one hour is coded as

A. 99359.   B. 99358.   C. 99361.   D. 99360.

 

5.   A 57-year-old patient is admitted to the hospital for a hip arthroscopy procedure. The patient is a normal healthy patient with no systemic disease. What anesthesia CPT code should be assigned?

A. 01242-P2   B. 01202-P1   C. 01202-P3   D. 01202-P5

 

6.   Anesthesia for procedures performed on the larynx and trachea in an 11-month-old child would be assigned to code

A. 00620.   B. 00625.   C. 00326.   D. 00532.

 

7.   A patient returns for a follow-up office visit regarding the repair of her fractured knee. The office visit consists of a detailed history, detailed examination, and medical decision making of moderate complexity. What CPT code is assigned?

A. 99213   B. 99212   C. 99211   D. 99214

 

8.   Intramuscular nonhormonal antineoplastic chemotherapy administration would be assigned to code

A. 96402.   B. 96405.   C. 96406.   D. 96401.

 

9.   Home infusion with specialty drug administration during a 6-hour visit would be assigned what codes?

A. 99606, 99607 ×3   B. 99601, 99602 ×4   C. 99604, 99605 ×2   D. 99603, 99604 ×2

 

10.   A patient is seen for a psychiatric diagnostic evaluation. The physician obtains a complete history of the patient’s mental status and does a complete biological and psychosocial assessment along with a complete physical examination. The physician’s final diagnosis is recurrent episode of severe major depressive disorder, without any psychotic behavior involved. The patient also has a history of psychological trauma. What codes are assigned?

A. F33.2, Z91.49   B. F33.1, Z91.47   C. F34.2, Z91.49   D. F36.2, Z91.46

 

11.   A 17-year-old patient is diagnosed with a severe form of nutritional anemia. What ICD-10-CM code should be assigned?

A. D45.9   B. D53.9   C. D74.9   D. D65.9

 

12.   A 32-year-old patient receives anesthesia for spinal surgery. The anesthesia is complicated by utilization of controlled hypotension. What add-on anesthesia code would be assigned?

A. 99174   B. 92117   C. 99100   D. 99135

 

13.   Nursing facility discharge day management of 19.5 minutes would be assigned to code

A. 99317.   B. 99319.   C. 99316.   D. 99315.

 

14.   A patient is admitted to the hospital for leukemia. She has a comprehensive history, comprehensive examination, and medical decision making of high complexity. What CPT code should be assigned?

A. 99202   B. 99223   C. 99213   D. 99251

 

15.   A service that is rarely provided, unusual, variable, or new may require a

A. physician’s authorization.   B. patient’s authorization.   C. staged or related procedure.   D. special report.

 

16.   A new patient is seen for a prescription refill. During the visit, the physician obtains a problem focused history, problem focused examination, and medical decision making is straightforward. What CPT code should be assigned for this service?

A. 99214   B. 99215   C. 99213   D. 99201

 

17.   A 7-year-old child is brought to the clinic due to recurrent ear infections. The physician performs a bilateral tympanostomy under general anesthesia. What CPT code should be assigned?

A. 69436-50   B. 69536-50   C. 69426-50   D. 69736-50

 

18.   Code 00906 is assigned for

A. an angioscopy.   B. anesthesia for surgery performed on the bony pelvis.   C. an osteotomy.   D. anesthesia provided for a vulvectomy.

 

19.   A 25-year-old patient receives a Hepatitis A vaccination. The vaccine is administered intramuscularly in the clinic. What CPT codes should be assigned?

A. 90632, 90471   B. 90541, 90489   C. 90637, 90472   D. 90672, 90451

 

20.   A dark adaptation examination with interpretation and report is assigned to code

A. 92326.   B. 92284.   C. 92287.   D. 92325.

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Socioeconomic-The more premature an infant is at birth, the greater the cost to care for the infant both on the family and on the healthcare system, as these infants require longer hospital stays and more extensive testing, medications and procedures. (Bowers, 2013, p. 29) Quite often the parents or other caregivers are forced to resort to becoming full-time caregivers and leave gainful employment. This places additional stress and financial burden on the families of these ELBW babies. Maternal stress is likely to increase as the mother may feel a sense of failure having given birth to an ELBW infant, leading to higher risk of postpartum depression and additional stress on the whole family.

Ongoing care– Need for ongoing early intervention services throughout childhood also contributes to the cost of raising a child born ELBW. Prematurity and low birth weight also increases the risk of readmission early in life, raising the overall cost to the family and increasing risks of hospital-acquired infections. Payment for routine and specialized care may be a challenge if the parent who carries insurance coverage for the child is unable to work and therefore loses employer-based health coverage.

Comorbidities-ELBW babies are at increased risk of fetal and neonatal death as well as long-term complications in adulthood like obesity, hypertension, diabetes and impaired fertility. (Bowers, 2013, p. 30) Short -term risks in ELBW infants include difficulties regulating temperature and blood sugar, risk for infection, renal failure and bleeding disorders. Many infants later demonstrate delays in motor development, speech delays and hearing impairment.

Ethnic and cultural disparities related to low birth weight babies- According to Bowers (2013), Non-Hispanic Black women are more likely to have a premature/LBW baby than a Non-Hispanic White woman, and while risk factors may include social stress, ethnicity alone, infection, inflammation, and genetic factors, the one factor most indicative of preterm delivery of a LBW infant is a previous preterm delivery.

One segment of our text pointed out that some cultures or ethnicities have varying views on infant death or death at any age, so the approach to care may differ greatly in those cultures and not have a direct association with the economic status of the family or culture or resources available to care for the ELBW infant. (Bowers, 2013, p. 29)

Support service from my community & Link and its effectiveness-

“WIC promotes the birth of healthy infants by preventing low birth weight, the leading cause of infant death and disability. The program provides prescribed supplemental foods, nutrition education and counseling, and referral to health care and other needed services for persons at nutritional risk. Eligibility includes: pregnant and nursing women and infants and children up to age 5.” (“Maternal and child health services | Schenectady County,” 2019)

https://www.fns.usda.gov/wic

Effectiveness– I chose to highlight the WIC program because it aims at prevention. A big part of addressing ELBW means looking at prenatal factors that may contribute to the risk of a low birth weight infant. Pregnant women are provided with appropriate nutrition through payment vouchers, while meeting with peer counselors and staff to learn about proper nutrition, prenatal care, breastfeeding preparation and many other services. Once a mother delivers her baby, the support continues through supplemental nutrition for the mother and child, help purchasing formula or breastfeeding support including breast pumps and peer counseling. The WIC program may be effective at reducing the risk of ELBW babies if the cause of low birth weight was related to the availability of proper nutrition for the mother while pregnant, or due to the lack of proper regular prenatal care. Once an ELBW infant is born, WIC may be effective at assisting the family already facing financial challenges with obtaining proper nutrition for the infant (then child up to age 5) as needed to ensure adequate growth and development.

References

Bowers, B. (2013). Prenatal, intrapartal, and postpartal risk factors. In C. Kenner & J. Lott (Eds.), Comprehensive neonatal nursing care (5th ed.,           pp. 28-30). Retrieved from https://ebookcentral-proquest-com.lopes.idm.oclc.org

Maternal and child health services | Schenectady County. (2019). Retrieved from https://www.schenectadycounty.com/node/413

SECOND COMMENT

It is very unfortunate that low birth babies affect the family and community. Personally, as a nurse, infants, and babies are my weakness, not my focus of study, and something I do not enjoy. Not to sound harsh, but we all have our preferences as individuals. There are many short and long term impacts, socioeconomic implications, and of course the need for ongoing care. The more premature an infant is at birth will determine the costliness to care for them. Medications, special treatments, and the amount of time spent in the hospital alone can deter the entire family’s road to recovery and the happiness which should be shared when having a newborn. These infants need ongoing care and many times family members end up being their caretakers full time and not working anymore and money can become sparse and the child can then be looked at as a burden. Several comorbidities include hypertension, diabetes mellitus, and increased risk of obesity. (Bowers, 2013) The at-risk group includes black women due to lifestyle and economic factors. The ethnic group opposite of that are Hispanic women. These 2 groups I am very familiar with, however, when it comes to children, I am uneducated. Hopefully, this course will make me more aware.

I am using FAN as my community resource. FAN is committed to providing free (which is of utmost importance) high-quality resources for supporting parents and the family. There is actually a woman who is part of the Family Advisory Staff who give here email. ErikaGoyer@gmail.com This website is so important and easy for all to access, get educated, donate, sponsor, and be a part of this wonderful organization.

(nationalperinatal.org)

Effectiveness is very well received. You can become a member of this group, make donations for families in need, and there are many more ways to simply get involved. You can actually become a sponsor to help other families see and feel what you went through and help all along the way.

REFERENCE:

Bowers, B. (2013). Prenatal, intrapartal, and postpartal risk factors.

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Chief complaint

An 84-year-old man was found by his daughter on the floor of his apartment after failing to answer the telephone for a day. He complained of pain in his left knee, but otherwise is confused and unable to explain what had occurred. He was brought to the hospital by ambulance and admitted.

Past Medical/Surgical History – provided by the daughter

Chronic Obstructive Pulmonary Disease (COPD)

Myocardial infarction (MI) 10 years ago

Hypertension (HTN)

Peptic ulcer disease with bleeding 20 years ago

Benign prostatic hypertrophy (BPH)

Venous insufficiency

Bilateral cataract surgery 5 years ago

Left inguinal hernia repair 25 years ago

Medications:

Aspirin 325 mg daily Atenolol 50 mg daily Multivitamin daily

Vitamin E 800 U daily terazosin 5 mg daily Lisinopril 10 mg daily

Vitamin C 1000 mg daily Ginkgo biloba daily

Social History – provided by the daughter

He lives alone and is able to care for himself. A woman cleans his apartment twice weekly and also does some shopping. His daughter is very involved and calls about every third day. He was a bookkeeper, retired at age 65 and became a widower at age 70. He manages his own finances and enjoys baseball on TV. He denies any recent change in appetite, has some rolls and coffee for breakfast, lunch at the senior center, and for dinner, he usually warms something left by his cleaning lady or eats at a restaurant near his home. He smoked 2 packs a day from age 20 to age 55 when he stopped after an episode of pneumonia. He rarely drinks more than one drink an evening. He does not exercise, and takes his medications as prescribed.

Physical Examination:

In the emergency room, his physical examination revealed a thin, frail male who appears alert but agitated and in moderate pain, lying on the stretcher.

Lung sounds with coarse crackles posterior in the right lung base

His vital signs were:

Pulse 48 Oxygen Saturation 88% on room air Weight 125 lbs

Blood pressure lying down 190/70 Height 5 ft. 9 in.

Respiratory rate 26 labored Temperature 102 F

He has 2+ pitting pedal edema to his left foot, none to the right foot. Unable to palpate a pedal pulse to the left foot. 2+ strong pulse to the right foot. He has obvious shortening and external rotation of the left leg.

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Running head: EMERGING TECHNOLOGIES IN HEALTH CARE

1

EMERGING TECHNOLOGIES IN HEALTHCARE

Emerging Technologies and Impact on Nursing Practice

Healthcare has evolved in terms of technology and health information technology, facilitates storage, and information sharing (Altotaibi & Federico, 2017). Health Information Technology (HIT) was invented to improve medical outcomes, enhance patient safety, advance patient records and help in achieving a new standard for care (Kruse & Beane, 2018). In the U.S., the adaption of new technologies has resulted and improved patient outcomes and reduced medical errors. The Electronic Health Record is the most integrated technology that has changes how care is given. It has led to benefits like medication administration efficiency and effectiveness, improved outcomes, and cost-effectiveness (citation). The future of nursing calls for the understanding of the “technological tools and information systems while collaborating and coordinating care across teams of health professionals,” (Huston, 2013, Pg#). The purpose of this paper is to identify how new technologies change nursing practice, examine the benefits and challenges, and assess patient safety and quality

Nursing Technologies, Innovation, and Implementation

Nurses are facing a period of transition and must adjust quickly to new technologies and practices. The adjustment may mean new skill sets and continuing education (citation). To ensure the appropriate delivery of patient care, nurses must oversee care given to patients and coordinate care with other healthcare workers (Pepito, & Locsin, 2019). Huston (2013) discussed many emerging technologies that will change the practice of nursing, including (a) electronic health records, (b) less invasive and more accurate tools for diagnostics and treatment, and (c) genetics and genomics. Dewsbury and Ballard (2014) also discussed nurse call systems.

Evidence-based practice and reduced medical errors have been promoted by the use of Computerized physician order entry (CPOE) and Clinical Decision Support Systems (Khanna, & Yen, 2014). In the past, patient health records were in paper format. Hospitals and clinics would have only one folder for each patient containing all their medical records (Evans, 2016). Traditional paper health records were also very long and hard to read. Locating the patient history was a challenge for physicians and nurses. The electronic health record is the most integrated technology that has changed how care is given and making a huge impact on nursing (Huston, 2013). The quality of care provided by nurses’ results from the adoption of new technologies (Huston, 2013). Healthcare providers have access to critical patient information from multiple providers, 24 hours a day, 7 days a week, allowing for better coordinated care (Huston, 2013).

Nurse call systems are essential and have impacted patient safety (Dewsbury, & Ballard, 2014). Call systems can help to improve patient safety, communication, and overall quality of care. Nurse call systems have improved wireless communication between the nurses and the residents/patients. Better patient care has resulted due to the ability to prioritize using a call system (Dewsbury, & Ballard, 2014). Additionally, call systems are able to provide telehealth services by which patients can be monitored remotely (Dewsbury, & Ballard, 2014). The system allows for the sharing of information, promotes good nursing practice, the workload is managed hence mitigating risks and management of records. And monitoring the health conditions of a patient (Dewsbury, & Ballard, 2014).

Due to workforce shortage and a growing elder population, new technologies like robotics have a huge impact on healthcare and the future of nursing practice (Huston, 2013). Robotics are used in many areas include nanomedicine, biomechatronic, and as direct care providers (Huston, 2013). Japan is one of the first to use robots widely to care for the elderly in a nursing home (citation). Robotics not only help patients but also reduce physical work strain of nurses (citation). Nurses often suffer from back injuries (citation). Robotic assistance may be useful in preventing nursing injuries (citation). Robots can also communicate and lead patients through a variety of recreational activities, which may be beneficial to patients with dementia (citation). Nurses who initiate innovation and embrace technology contribute to improved health outcomes (citation).

“Less invasive and more accurate tools for diagnostics and treatment will also change nursing practice in the future”. For example, heart disease is likely to be diagnosed by a new blood test that eliminates the need for risky diagnostic angiograms,” (Huston, 2013, Pg. #). Minimally invasive surgery results in less operative trauma for the patient compared to open invasive procesures (Kuma, Yadav, Singh, Chauhan, & Neha, 2016). Less pain and hospitalization time. It will also help speed up the rehabilitation and decreases the rate of postsurgical complications (Kumar, et al, 2016). In addition, magnets are increasingly used as a treatment for major depression (Huston, 2013). As a therapeutic intervention for depression, a small electromagnet is placed on the scalp behind the left forehead (Huston, 2013).

Bar-coding

· Benefits

· Challenges

Specialized tubing for feeding that is incompatible with IV tubing

· Benefits

· Challenges

Smart pumps

· Benefits

· Challenges

Patient safety and quality improvement

One paragraph on this

New nursing profession

References

Calzone, K. A., Cashion, A., Feetham, S., Jenkins, J., Prows, C.A., Williams, J.K. & Wung, S.F. (2010). Nurses transforming health care using genetics and genomics. Nursing Outlook, 58 (1), 26-35. doi: 10.1016/j.outlook.2009.05.001

Darvish, A., Bahramnezhad, F., Keyhanian, S., & Navidhamidi, M. (2014). The role of nursing informatics on promoting quality of health care and the need for appropriate education. Global journal of health science, 6(6), 11–18. doi:10.5539/gjhs.v6n6p11

Dewsbury, G., & Ballard, D. (2014). Emerging technology: Nurse call systems: Nursing and Residential Care, 16(8), 446-449.

De Veer, A. J., Fleuren, M. A., Bekkema, N., & Francke, A. L. (2011). Successful implementation of new technologies in nursing care: A questionnaire survey of nurse users. BMC medical informatics and decision making, 11, 67. doi:10.1186/1472-6947-11-67.

Evans R.S. (2016). Electronic health records: Then, now, and in the future. Yearbook of medical informatics, Suppl 1(Supp 1), S48-S61. Doi: 10.15265/IYS-2016-s006

Huston, C. (2013). The impact of emerging technology on nursing care: Warp speed ahead. OJIN: The Online Journal of Issues in Nursing, 18(2), Manuscript 1. doi:10.3912/OJIN.Vol18No02Man01

Pepito, A. J., Locsin, R. (2019). Can nurses remain relevant in a technologically advanced future. International Journal of Nursing Sciences 106-110 doi:10.1016/j.ijnss.2018.09.013

Shorr, R. I., Chandler, A. M., Mion, L. C., Waters, T. M., Liu, M., Daniels, M. J., … Miller, S. T. (2012). Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: A cluster randomized trial. Annals of internal medicine, 157(10), 692–699. doi:10.7326/0003-4819-157-10-201211200-00005.

Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi medical journal, 38(12), 1173–1180. doi:10.15537/smj.2017.12.20631

Kruse, C. S., & Beane, A. (2018). Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review. Journal of medical Internet research, 20(2), e41. doi:10.2196/jmir.8793

Kumar, A., Yadav, N., Singh, S., & Chauhan, N. (2016). Minimally invasive (endoscopic computer assisted) surgery: Technique and review. Annals of maxillofacial surgery, 6(2), 159–164. doi:10.4103/2231-0746.200348

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Please reply with one reference to the following post:

Week 1 Discussion

Nursing revolves around the patient, the nurse, the patient’s health, and the environment. Therefore, these four concepts are known as the metaparadigms of nursing. There are many additional concepts that come to mind when I think of nursing. As a registered nurse, I feel as if collaboration and advocacy are two additional concepts that are relevant to my personal practice.

Collaboration is defined as “working with others in a way that promotes/encourages each person’s contributions toward achieving optimal/realistic patient/family goals” (Butts & Rich, 2018). In my opinion, working in the healthcare field truly requires amazing teamwork. A patient cannot heal purely by the medications the nurse gives them every morning. They must walk with physical therapy to get stronger, they must get their breathing treatments from the respiratory therapist, their labs have to be drawn by the phlebotomist, the radiologists must read their x-rays, and the physician must speak to/evaluate the patient each day to ensure that his/her goals are being met. Thankfully, I work in an environment where collaboration is welcomed. As the nurse, physicians often ask my opinion, as I have a closer relationship to the patient. Collaboration is most successful when there is active communication regarding patient care, and the correct resources are used to optimize patient outcomes (Butts & Rich, 2018).

Advocacy is the second concept that I feel is relevant to my personal practice. According to Butts and Rich (2018), advocacy is defined as “working on another’s behalf and representing the concerns of the patient/family and nursing staff.” On a daily basis, I find myself advocating for my patients. I do this by keeping the entire healthcare team informed, providing assistance or getting them in touch with the correct people to get them assistance, and providing professional nursing care. Working on an orthopedic unit, I most often find myself advocating for my patient regarding their pain. As nurses, we are taught that “pain is what the patient says it is.” If I feel as if my patient does not have adequate pain control, I am quick to call the physician. By advocating for my patients, I want to ensure that they get the proper care to optimize their health and outcomes.

Reference

Butts, J. B., & Rich, K. L. (2018). Philosophies and theories for advanced nursing practice (3rd ed.).

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Provide a critique Kristen Swanson’s Theory of Caring, making sure to identify benefits, consequences and feasibility of application in clinical practice as a family nurse practitioner. Provide evidence using 2 (two) scholarly articles in order to support your critique.

Identify a state health policy and the tools used to implement the policy. How do you think the political climate has affected the choice of policy tools and the behavioral assumptions by policymakers?  How have professional nursing organizations been involved in this policy issue? If they have not, what recommendations would you make for them to participate?  Develop a few talking points to inform other health care professionals regarding this issue.

Good news! You have been asked to represent your organization at the annual Healthcare Facilities Planning conference in Hawaii. Your specific assignment is to attend a presentation by Ray Dufresne on best practices for capital planning and, when you return, to tell your boss which of Dufresne’s practices you think is most essential for ensuring that your organization’s capital plan will be successful.

After reading “Best Practices in Healthcare Facilities Capital Planning,” identify the best practice that you think is most essential for ensuring that an organization’s capital plan will be successful, and explain why you think it is most essential.

Article attached below.

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