MDC11腎及泌尿道疾病PPT.pptVIP

MDC11腎及泌尿道疾病 黃素勤 96/06/22 習題演練 例題一 The patient was a case of hypertension，end stage renal disease on regular hemodialysis，this time，he suffered chillnes for 3-4days and dyspnea for 2days，he brought to ER and CXR showed acute pulmonary edema 出院診斷: 1.ESRD on HD with Acute pulmonary edema 2.HCVD emergent HD was done 解答 編法一： 518.4+404.92+39.95 MDC :4 DRG:0.9405 幾何平均住院日： ５天 RW：0.4763 編法二: 404.92+518.4+39.95 MDC :11 DRG:31601 幾何平均住院日： 7天 RW：1.6718 RW差 -1.1955 例題二 The patient visited OPD due to bilateral flank pain for 2days , KUB showed bilateral ureteral stone and renal echo showed bilateral hydronephrosis 　 出院診斷： 1.bilateral lower ureteral stone 2.bilateral hydronephrosis 3. sepsis with UTI E-coli infection OP: bilateral ureteroscopy + stone manipulation(URS-SM) + Double-j was indwelled 解答 Stone ureter 592.0 hydronephrosis 591 Septicemia with Escherichia coli 038.42 Infection urinary 599.0 Removal ureter without incision 56.0 Insertion ureteral stent 59.8 若sepsis 與UTI所感染的菌種相同時,則UTI不需再加編菌 種碼 因輸尿管為對稱器官,故當雙側皆施行手術時,皆需編碼 例題三 出院診斷： 1.End stage renal disease 2.Diabetes mellitus with nephropathy 3.Hypertension 4.Gouty arthritis 5.Hyperlipidemia 6.Hepatitis B 手術: 1.on double lumen catheter for dialysis 　　 2.H/D 解答 代碼: 診斷碼: 403.91+250.40+274.0+070.30+272.4+583.81 處置碼:38.95+39.95 MDC 11 DRG 31601(腎衰竭，有合併症或併發症，洗腎) 若診斷無法明示糖尿病腎病變導致腎衰竭，則仍應加編583.81