Analyze the ethical considerations that apply

/in /by

Juanitas World 1

Juanita is meeting with her new boss, Rich Ryblessi, the Director of Regional Services. Rich highlights his concerns in the following areas: analysis and design of work, recruitment and selection, training and development, performance management, compensation and benefits, employee relations, personnel policies, compliance with laws, and strategies for supporting the mission.

At the end of the meeting Juanita returns to her office and reflects on the meeting. As best as she can determine, HR has typically been relegated to simply processing paperwork and counseling people who had questions about issues like health insurance and paychecks. And although Rich has identified many important areas for HR, Juanita senses that he really expects no more from her than he did of the previous HR Manager. However, Juanita believes she can and should contribute more to the mission and vision and can help Rich overcome a number of challenges.

Juanitas World 2

 

Yesterday was a bit of a surprise for Juanita as she sensed a gap between what her boss said he wanted and what he conveyed as expectations and limits on her authority. It is now Day 2 and she is excited and ready to go with her early afternoon appointment with fundraising’s Director of Development.

As she is reviewing past reports on fundraising efforts and success a visitor stops in to see her. When Melissa, introduces herself Juanita finds that she is the previous HR Manager who left the organization about 3 months earlier. Juanita perceives this is an ideal time to glean what she can about challenges and opportunities. While speaking with Melissa, Juanita finds out who the real workers are and who just seems to be filling a spot. She learns that since resources are limited they have struggled to find qualified and committed personnel to fill numerous important positions. Juanita finds that the people do care…a lot…about the mission but hardly think beyond their current circumstances and most are discouraged with their perceived lack of impact on their community. When Juanita questions Melissa about why she left she finds that Melissa had aspired to have greater responsibility and make a bigger impact but felt limited in her role in this organization. In a way, this confirmed for Juanita that she would definitely have to speak with Rich sooner than later to be sure she understood her authority to do all she thought she was hired to do.

As she visits with Jackie, the Director of Development, she learns that the economy has had a negative impact on their historical donor base. Cash gifts are down and have been trending down for about 2 years. Gifts in kind, like food, are up but since it is perishable they must distribute it quickly or it must be thrown away. And, since gifts are down they have had to rely more heavily on volunteers. This means their drivers and those who distribute food are less consistent and reliable. This is beginning to impact their gifts from donors since they are finding out that much of what they are giving is being thrown away.

As Juanita sits in her office at the end of the day she feels she is beginning to understand the complexity of the issues. It seems she has limited authority over areas that most HR Managers have and that the lack of cash is negatively impacting their ability to hire and retain the right people. Since she cannot control the availability of cash she will have to come up with some innovative ways to better hire and retain the right people.

 

 

Juanitas world 3

 

While attending one of her last classes last night Juanita learned of an assignment she has related to Equal Employment Opportunity (EEO). As she is driving home from class she realizes that her new employer would be a great source for the assignment and help her better understand how to do her job better.

When she met with Rich he never mentioned laws and regulations that may impact the organizations. And, when she thinks about it, she had assumed that since they were a non-profit doing work to alleviate hunger that they would somehow be exempt from government oversight.

Her appointment for Day 3 has cancelled so she decides to use the day to learn what she can about laws and regulations that they could be potentially violating and also try to better understand how they could use them to their advantage.

 

Juanitas World 4

 

It is Juanita’s 4th day on the job and it has been both exciting and scary. The more she learns the more she realizes she has to learn if she is to be successful in this new role. Based on her observations in previous jobs and as an intern at her last non-profit experience, it seemed as if the pace was slow and easy. To her surprise and with great anticipation, she is finding that there is much to be done to help this organization that she is so committed to.

Her passion and commitment runs deep as a first generation Hispanic American in her family. She remembers the trouble her family had finding suitable housing, food, and work when they first came to America when she was just 6 years old. Much has changed for her and her family but not without pain and sacrifice. Juanita is determined to make a difference for those who have little ability to help themselves. And, as far as she is concerned, this applies to all the stakeholders she will serve including the hungry, employees, employer, and the community at large.

Although there is much to do she remembers what her mama taught her….you eat an elephant one bite at a time. Based on this counsel she decides to establish some short term priorities based on what she has learned so far. From what she has heard during her first conversations with managers and what she hears from various employees, it seems the greatest need the organization has is to stabilize the employee base.

Her own job description seems inadequate for what the job will entail and she wonders if this is true of other jobs. She wonders if job descriptions are designed to reflect what is or what used to be when the organization was just getting started. And, how have they historically planned for their needs or have they merely reacted to changing requirements?

 

 

 

Juanitas World 5

uanita feels she is developing rapport and trust with a number of the people she

has visited with. It seems obvious that hiring and retaining the right people is

critical to long term success. As she has probed deeper into the issues she has

turned up some details on performance appraisals…or lack thereof, a weakness

in employee and volunteer development and a significant lack of training.

Given these difficulties she decides the best way to gather information without

having to schedulee more appointments with people she has already visited is

to simply engage in some discussion via email. She builds her group list and then begins to compose her email.

“….thank you for taking the time to help me feel welcome and for sharing

your perspective on how HR and I can better help you accomplish your

goals as well as the mission that we share. As I continue to meet with

various people I find that most challenges we face point back to training

and development, our performance evaluation system and related

feedback, and a lack of a career track for full time employees. I am hoping

you will help me out by responding to a few questions by email so I can

keep thinking about these issues without having to make another appointment with you so soon after our initial meeting.”

 

 

o Evaluate the cultural issues that need to be addressed

o Analyze the ethical considerations that apply

 

The difference between knowledge and belief seems pretty clear.

/in /by

THIS ASSIGNMENT IS DUE 8-3-13

What is the difference between what is known and what is believed? It may seem like an obvious question, but if you look below the surface and really investigate the difference between knowledge and belief, you may find yourself second-guessing some of your most basic assumptions.

As a general definition, knowledge is something that is believed to be true and can be backed up with evidence. A belief is something that is believed to be true, but there is not adequate evidence.

The difference between knowledge and belief seems pretty clear. However, how much evidence does it take to change a belief into knowledge? And, who decides what kind of evidence is reliable? Should knowledge be based on empiricism (knowledge that comes from experiencing the physical world), reason (knowledge that comes from logic), or a combination of both?

Take a moment to reflect on these concepts, and then write 2–3 pages on the following:

Think about someone in your life who loves you—it could be your mother, significant other, child, or even a pet.
Do you know this person loves you, or do you believe this person loves you?
State your argument for why you chose to categorize the idea as either knowledge or belief.
Give 3 pieces of empirical evidence for the knowledge or belief, as well as 3 logical reasons.
After looking through the evidence, do you still maintain your original categorization of knowledge or belief? Why?

Which of the following statements about literacy is true?

/in /by

Question 1

1.

The SBI case at the beginning of Chapter 10 where the women were treated so differently than the men, took place in

Answer

[removed] 1950’s.
[removed] 1960’s.
[removed] 1990’s.
[removed] it did not take place; it was made up to make a point.

4 points

Question 2

1.

________ are qualities of the manager as a person.

Answer

[removed] Technical knowledge and skills
[removed] KSAs
[removed] Personal traits
[removed] Value creation skills
[removed] Interpersonal knowledge and skills

4 points

Question 3

1.

Advantages of teamwork include

Answer

[removed] increased productivity.
[removed] improved job satisfaction.
[removed] lower absenteeism.
[removed] both A & B.
[removed] all of the above.

4 points

Question 4

1.

To understand a manager’s development needs, you must first understand _____.

Answer

[removed] the strategic direction of the organization
[removed] the technology of the manager’s unit
[removed] the manager’s unit structure in relation to the rest of the organization
[removed] both B& C
[removed] all of the above

4 points

Question 5

1.

Which of the following statements about literacy is true?

Answer

[removed] About five percent of the North American workforce is functionally illiterate.
[removed] The main reason that employers need to upgrade new employees in literacy skills is that most new employees do not finish high school.
[removed] In the training of literacy skills it is always best to use an outside consultant so employees will not feel embarrassed.
[removed] Graduates from high school often require remedial skills training

4 points

Question 6

1.

There is a special chapter on management development because

Answer

[removed] the manager’s job is clear so we can get very specific about their needs.
[removed] managers are accountable for success so they are a very important group.
[removed] managers rely so much on their declarative knowledge.
[removed] all of the above.

4 points

Question 7

1.

For the executive job rotation means

Answer

[removed] working in different departments of the organization
[removed] going to a subsidiary supplier for a while
[removed] being coached
[removed] it does not take place; job rotation is for managers and below

4 points

Question 8

1.

An important decisional role for a manager is:

Answer

[removed] leader.
[removed] spokesperson.
[removed] entrepreneur.
[removed] liaison.

4 points

Question 9

1.

In the example of Mary, the hearing impaired Accounting Clerk, which of the following statements is true when she applied for the accounting manager position?

Answer

[removed] You needed to be able to hear clearly in the job
[removed] You needed to have a university degree
[removed] She did not have the necessary KSA’s
[removed] She was not informed of the training where she could have gotten the KSA’s
[removed] Both C & D

4 points

Question 10

1.

The “quid pro quo” type of sexual harassment involves

Answer

[removed] using profanity in front of the opposite sex.
[removed] unwanted touching by another employee.
[removed] an offer of some job perks by a supervisor in exchange for sexual favors
[removed] both A & B.
[removed] all of the above.

4 points

Question 11

1.

What is the value of orientation training? How can you make sure it is effective?

Answer

30 points

Question 12

1.

Explain employee‑oriented styles. Make sure to include an explanation of the two employee‑oriented styles explained in the text.

Answer

 

Medical Billing & Coding

/in /by
  1. RADIOLOGY REPORT
    LOCATION: Outpatient, Hospital
    PATIENT: Eric Tayes
    ORDERING PHYSICIAN: Frank Gaul, MD
    ATTENDING/ADMIT PHYSICIAN: Frank Gaul, MD
    RADIOLOGIST: Morton Monson, MD
    EXAMINATION: Ultrasound of both lower extremities; abdomen ultrasound.
    CLINICAL SYMPTOMS: Lower extremity swelling, Respiratory distress.

    FINDINGS: Ultrasound examination of the deep venous system of both lower extremities is negative. No evidence of deep venous thrombosis in either lower extremity. The posterior tibial, greater saphenous, and popliteal through femoral veins are patent and negative for thrombus bilaterally. Normal phasicity.

    Abdomen Ultrasound: Diffusely coarsened echotexture of the liver with some nodularity consistent with fatty infiltration. Cirrhotic configuration of the liver. Small calcified granuloma in the spleen. The spleen is otherwise negative. There is ascites in all four quadrants. No bile duct dilatation. No gallbladder wall thickening or cholelithiasis. Small amount of fluid adjacent to the gallbladder is likely related to the ascites. The pancreas is obscured by bowel gas. The abdominal aorta is of normal caliber. The right kidney measures approximately 9 cm in length and shows no evidence of hydronephrosis, calculi, or mass. The left kidney measures approximately 9.9 cm in length and shows no evidence of hydronephrosis, calculi, or mass.

    Which physician are you coding for? __________________________________

  2. RADIOLOGY REPORT
    LOCATION: Outpatient, Hospital
    PATIENT: Eric Tayes
    ORDERING PHYSICIAN: Frank Gaul, MD
    ATTENDING/ADMIT PHYSICIAN: Frank Gaul, MD
    RADIOLOGIST: Morton Monson, MD
    EXAMINATION: Ultrasound of both lower extremities; abdomen ultrasound.
    CLINICAL SYMPTOMS: Lower extremity swelling, Respiratory distress.

    FINDINGS: Ultrasound examination of the deep venous system of both lower extremities is negative. No evidence of deep venous thrombosis in either lower extremity. The posterior tibial, greater saphenous, and popliteal through femoral veins are patent and negative for thrombus bilaterally. Normal phasicity.

    Abdomen Ultrasound: Diffusely coarsened echotexture of the liver with some nodularity consistent with fatty infiltration. Cirrhotic configuration of the liver. Small calcified granuloma in the spleen. The spleen is otherwise negative. There is ascites in all four quadrants. No bile duct dilatation. No gallbladder wall thickening or cholelithiasis. Small amount of fluid adjacent to the gallbladder is likely related to the ascites. The pancreas is obscured by bowel gas. The abdominal aorta is of normal caliber. The right kidney measures approximately 9 cm in length and shows no evidence of hydronephrosis, calculi, or mass. The left kidney measures approximately 9.9 cm in length and shows no evidence of hydronephrosis, calculi, or mass.

    Identify the correct ICD-9-CM diagnosis code(s) for the above scenario:

    ICD-9-CM _________,

    ICD-9-CM _________,

    ICD-9-CM _________

  3. RADIOLOGY REPORT
    LOCATION: Outpatient, Hospital
    PATIENT: Eric Tayes
    ORDERING PHYSICIAN: Frank Gaul, MD
    ATTENDING/ADMIT PHYSICIAN: Frank Gaul, MD
    RADIOLOGIST: Morton Monson, MD
    EXAMINATION: Ultrasound of both lower extremities; abdomen ultrasound.
    CLINICAL SYMPTOMS: Lower extremity swelling, Respiratory distress.

    FINDINGS: Ultrasound examination of the deep venous system of both lower extremities is negative. No evidence of deep venous thrombosis in either lower extremity. The posterior tibial, greater saphenous, and popliteal through femoral veins are patent and negative for thrombus bilaterally. Normal phasicity.

    Abdomen Ultrasound: Diffusely coarsened echotexture of the liver with some nodularity consistent with fatty infiltration. Cirrhotic configuration of the liver. Small calcified granuloma in the spleen. The spleen is otherwise negative. There is ascites in all four quadrants. No bile duct dilatation. No gallbladder wall thickening or cholelithiasis. Small amount of fluid adjacent to the gallbladder is likely related to the ascites. The pancreas is obscured by bowel gas. The abdominal aorta is of normal caliber. The right kidney measures approximately 9 cm in length and shows no evidence of hydronephrosis, calculi, or mass. The left kidney measures approximately 9.9 cm in length and shows no evidence of hydronephrosis, calculi, or mass.

    Identify the correct CPT-4 procedure code(s) for the above scenario:

    CPT-4: __________,

    CPT-4: __________

  4. RADIOLOGY REPORT
    LOCATION: Outpatient, Hospital
    PATIENT: Eric Tayes
    ORDERING PHYSICIAN: Frank Gaul, MD
    ATTENDING/ADMIT PHYSICIAN: Frank Gaul, MD
    RADIOLOGIST: Morton Monson, MD
    EXAMINATION: Ultrasound of both lower extremities; abdomen ultrasound.
    CLINICAL SYMPTOMS: Lower extremity swelling, Respiratory distress.

    FINDINGS: Ultrasound examination of the deep venous system of both lower extremities is negative. No evidence of deep venous thrombosis in either lower extremity. The posterior tibial, greater saphenous, and popliteal through femoral veins are patent and negative for thrombus bilaterally. Normal phasicity.

    Abdomen Ultrasound: Diffusely coarsened echotexture of the liver with some nodularity consistent with fatty infiltration. Cirrhotic configuration of the liver. Small calcified granuloma in the spleen. The spleen is otherwise negative. There is ascites in all four quadrants. No bile duct dilatation. No gallbladder wall thickening or cholelithiasis. Small amount of fluid adjacent to the gallbladder is likely related to the ascites. The pancreas is obscured by bowel gas. The abdominal aorta is of normal caliber. The right kidney measures approximately 9 cm in length and shows no evidence of hydronephrosis, calculi, or mass. The left kidney measures approximately 9.9 cm in length and shows no evidence of hydronephrosis, calculi, or mass.

    What modifier should be added to the CPT-4 code in order to submit the insurance claim?__________

  5. RADIOLOGY REPORT
    LOCATION: Outpatient, Hospital
    PATIENT: Eric Tayes
    ORDERING PHYSICIAN: Frank Gaul, MD
    ATTENDING/ADMIT PHYSICIAN: Frank Gaul, MD
    RADIOLOGIST: Morton Monson, MD
    EXAMINATION: Ultrasound of both lower extremities; abdomen ultrasound.
    CLINICAL SYMPTOMS: Lower extremity swelling, Respiratory distress.

    FINDINGS: Ultrasound examination of the deep venous system of both lower extremities is negative. No evidence of deep venous thrombosis in either lower extremity. The posterior tibial, greater saphenous, and popliteal through femoral veins are patent and negative for thrombus bilaterally. Normal phasicity.

    Abdomen Ultrasound: Diffusely coarsened echotexture of the liver with some nodularity consistent with fatty infiltration. Cirrhotic configuration of the liver. Small calcified granuloma in the spleen. The spleen is otherwise negative. There is ascites in all four quadrants. No bile duct dilatation. No gallbladder wall thickening or cholelithiasis. Small amount of fluid adjacent to the gallbladder is likely related to the ascites. The pancreas is obscured by bowel gas. The abdominal aorta is of normal caliber. The right kidney measures approximately 9 cm in length and shows no evidence of hydronephrosis, calculi, or mass. The left kidney measures approximately 9.9 cm in length and shows no evidence of hydronephrosis, calculi, or mass.

    What claim form will be submitted for the radiologist’s services? ______________

  6. HEMODIALYSIS PROGRESS NOTE

    LOCATION: Inpatient, Hospital
    PATIENT: Sandra Amada
    ATTENDING PHYSICIAN: George Orbitz, MD

    HEMODIALYSIS PROGRESS NOTE: The patient is seen and examined during hemodialysis. The patient appears to be hemodynamically stable, not in any form of respiratory distress or compromise.

    LABORATORY STUDIES: Latest labs were performed 4 weeks ago. Hemogram shows an H&H (hematocrit and hemoglobin) of 8.6/26.2. WBC (white blood count) is 9.9, normochromic/normocytic indices. Platelets are 143. There is left shift of 81.1% neutrophils. Sodium is 139, potassium 4, chloride 98, CO2 (carbon dioxide) is 30.7, BUN (blood urea nitrogen) and creatinine 31/3.4, glucose 121, and calcium 8.2. Today, we will dialyze her for a total of 4 hours using an HP-150 dialyzer via her right-sided Perm-A-Cath. We will use a 2.0 potassium bath, and we will not give her any heparin loading dose during this treatment.

    PHYSICAL EXAM: At present time, vital signs are stable. Blood pressure is 128/57. Heart rate is 80, and she is tolerating a blood flow rate of 500 ml (milliliter) per minute. Normocephalic and atraumatic. Pale palpebral conjunctivae, anicteric sclerae. No nasal or aural discharge. Moist tongue and buccal mucosa. No pharyngeal hyperemia, congestion, or exudates. Supple neck. No lymphadenopathy. Symmetrical chest. No retractions. Positive rhonchi. No crackles or wheezes. S1 (first heart sound) and S2 (second heart sound) distinct. No S3 (third heart sound) or S4 (fourth heart sound). Regular rate and rhythm. Abdomen: Positive bowel sounds, soft and nontender. No abdominal bruits. Both upper and lower extremities reveal arthritic changes. Pulses are fair.

    ASSESSMENT/PLAN:
    I.      End-stage renal disease (on maintenance hemodialysis, Monday, Wednesday, and Friday), most likely secondary to the following:
    A.      Hypertension. Continue same antihypertensive regimen as ordered.
    B.      Type 2 diabetes mellitus. Continue oral antidiabetic agents. Continue the same dialysis orders as above.
    C.      Previous chronic use of NSAID (nonsteroidal antiinflammatory drug)/COX-2 inhibitors.
    II.      Anemia due to chronic renal disease.
    III.      Questionable diverticulosis; status post multiple herniorrhaphies; status post- cholecystectomy.
    IV.      Discharge planning: The plan is to discharge the patient to rehabilitation medicine.
    At this time, the patient appears to be stable and is tolerating hemodialysis. We will continue to follow this patient from the renal/hemodialysis standpoint. She will get erythropoietin 10,000 units IV (intravenous) after hemodialysis today.

    In this scenario, which physician are you coding for?__________________________________

  7. HEMODIALYSIS PROGRESS NOTE

    LOCATION: Inpatient, Hospital
    PATIENT: Sandra Amada
    ATTENDING PHYSICIAN: George Orbitz, MD

    HEMODIALYSIS PROGRESS NOTE: The patient is seen and examined during hemodialysis. The patient appears to be hemodynamically stable, not in any form of respiratory distress or compromise.

    LABORATORY STUDIES: Latest labs were performed 4 weeks ago. Hemogram shows an H&H (hematocrit and hemoglobin) of 8.6/26.2. WBC (white blood count) is 9.9, normochromic/normocytic indices. Platelets are 143. There is left shift of 81.1% neutrophils. Sodium is 139, potassium 4, chloride 98, CO2 (carbon dioxide) is 30.7, BUN (blood urea nitrogen) and creatinine 31/3.4, glucose 121, and calcium 8.2. Today, we will dialyze her for a total of 4 hours using an HP-150 dialyzer via her right-sided Perm-A-Cath. We will use a 2.0 potassium bath, and we will not give her any heparin loading dose during this treatment.

    PHYSICAL EXAM: At present time, vital signs are stable. Blood pressure is 128/57. Heart rate is 80, and she is tolerating a blood flow rate of 500 ml (milliliter) per minute. Normocephalic and atraumatic. Pale palpebral conjunctivae, anicteric sclerae. No nasal or aural discharge. Moist tongue and buccal mucosa. No pharyngeal hyperemia, congestion, or exudates. Supple neck. No lymphadenopathy. Symmetrical chest. No retractions. Positive rhonchi. No crackles or wheezes. S1 (first heart sound) and S2 (second heart sound) distinct. No S3 (third heart sound) or S4 (fourth heart sound). Regular rate and rhythm. Abdomen: Positive bowel sounds, soft and nontender. No abdominal bruits. Both upper and lower extremities reveal arthritic changes. Pulses are fair.

    ASSESSMENT/PLAN:
    I.      End-stage renal disease (on maintenance hemodialysis, Monday, Wednesday, and Friday), most likely secondary to the following:
    A.      Hypertension. Continue same antihypertensive regimen as ordered.
    B.      Type 2 diabetes mellitus. Continue oral antidiabetic agents. Continue the same dialysis orders as above.
    C.      Previous chronic use of NSAID (nonsteroidal antiinflammatory drug)/COX-2 inhibitors.
    II.      Anemia due to chronic renal disease.
    III.      Questionable diverticulosis; status post multiple herniorrhaphies; status post- cholecystectomy.
    IV.      Discharge planning: The plan is to discharge the patient to rehabilitation medicine.
    At this time, the patient appears to be stable and is tolerating hemodialysis. We will continue to follow this patient from the renal/hemodialysis standpoint. She will get erythropoietin 10,000 units IV (intravenous) after hemodialysis today.

    Identify the correct (ICD-9-CM) diagnosis code(s) for the above scenario:

    ICD-9-CM __________,

    ICD-9-CM __________,

    ICD-9-CM __________,

    ICD-9-CM __________.

  8. HEMODIALYSIS PROGRESS NOTE

    LOCATION: Inpatient, Hospital
    PATIENT: Sandra Amada
    ATTENDING PHYSICIAN: George Orbitz, MD

    HEMODIALYSIS PROGRESS NOTE: The patient is seen and examined during hemodialysis. The patient appears to be hemodynamically stable, not in any form of respiratory distress or compromise.

    LABORATORY STUDIES: Latest labs were performed 4 weeks ago. Hemogram shows an H&H (hematocrit and hemoglobin) of 8.6/26.2. WBC (white blood count) is 9.9, normochromic/normocytic indices. Platelets are 143. There is left shift of 81.1% neutrophils. Sodium is 139, potassium 4, chloride 98, CO2 (carbon dioxide) is 30.7, BUN (blood urea nitrogen) and creatinine 31/3.4, glucose 121, and calcium 8.2. Today, we will dialyze her for a total of 4 hours using an HP-150 dialyzer via her right-sided Perm-A-Cath. We will use a 2.0 potassium bath, and we will not give her any heparin loading dose during this treatment.

    PHYSICAL EXAM: At present time, vital signs are stable. Blood pressure is 128/57. Heart rate is 80, and she is tolerating a blood flow rate of 500 ml (milliliter) per minute. Normocephalic and atraumatic. Pale palpebral conjunctivae, anicteric sclerae. No nasal or aural discharge. Moist tongue and buccal mucosa. No pharyngeal hyperemia, congestion, or exudates. Supple neck. No lymphadenopathy. Symmetrical chest. No retractions. Positive rhonchi. No crackles or wheezes. S1 (first heart sound) and S2 (second heart sound) distinct. No S3 (third heart sound) or S4 (fourth heart sound). Regular rate and rhythm. Abdomen: Positive bowel sounds, soft and nontender. No abdominal bruits. Both upper and lower extremities reveal arthritic changes. Pulses are fair.

    ASSESSMENT/PLAN:
    I.      End-stage renal disease (on maintenance hemodialysis, Monday, Wednesday, and Friday), most likely secondary to the following:
    A.      Hypertension. Continue same antihypertensive regimen as ordered.
    B.      Type 2 diabetes mellitus. Continue oral antidiabetic agents. Continue the same dialysis orders as above.
    C.      Previous chronic use of NSAID (nonsteroidal antiinflammatory drug)/COX-2 inhibitors.
    II.      Anemia due to chronic renal disease.
    III.     Questionable diverticulosis; status post multiple herniorrhaphies; status post- cholecystectomy.
    IV.      Discharge planning: The plan is to discharge the patient to rehabilitation medicine.
    At this time, the patient appears to be stable and is tolerating hemodialysis. We will continue to follow this patient from the renal/hemodialysis standpoint. She will get erythropoietin 10,000 units IV (intravenous) after hemodialysis today.

    Identify the correct procedure code (CPT-4) for the above scenario:

    CPT-4 __________

  9. HEMODIALYSIS PROGRESS NOTE

    LOCATION: Inpatient, Hospital
    PATIENT: Sandra Amada
    ATTENDING PHYSICIAN: George Orbitz, MD

    HEMODIALYSIS PROGRESS NOTE: The patient is seen and examined during hemodialysis. The patient appears to be hemodynamically stable, not in any form of respiratory distress or compromise.

    LABORATORY STUDIES: Latest labs were performed 4 weeks ago. Hemogram shows an H&H (hematocrit and hemoglobin) of 8.6/26.2. WBC (white blood count) is 9.9, normochromic/normocytic indices. Platelets are 143. There is left shift of 81.1% neutrophils. Sodium is 139, potassium 4, chloride 98, CO2 (carbon dioxide) is 30.7, BUN (blood urea nitrogen) and creatinine 31/3.4, glucose 121, and calcium 8.2. Today, we will dialyze her for a total of 4 hours using an HP-150 dialyzer via her right-sided Perm-A-Cath. We will use a 2.0 potassium bath, and we will not give her any heparin loading dose during this treatment.

    PHYSICAL EXAM: At present time, vital signs are stable. Blood pressure is 128/57. Heart rate is 80, and she is tolerating a blood flow rate of 500 ml (milliliter) per minute. Normocephalic and atraumatic. Pale palpebral conjunctivae, anicteric sclerae. No nasal or aural discharge. Moist tongue and buccal mucosa. No pharyngeal hyperemia, congestion, or exudates. Supple neck. No lymphadenopathy. Symmetrical chest. No retractions. Positive rhonchi. No crackles or wheezes. S1 (first heart sound) and S2 (second heart sound) distinct. No S3 (third heart sound) or S4 (fourth heart sound). Regular rate and rhythm. Abdomen: Positive bowel sounds, soft and nontender. No abdominal bruits. Both upper and lower extremities reveal arthritic changes. Pulses are fair.

    ASSESSMENT/PLAN:
    I.      End-stage renal disease (on maintenance hemodialysis, Monday, Wednesday, and Friday), most likely secondary to the following:
    A.      Hypertension. Continue same antihypertensive regimen as ordered.
    B.      Type 2 diabetes mellitus. Continue oral antidiabetic agents. Continue the same dialysis orders as above.
    C.      Previous chronic use of NSAID (nonsteroidal antiinflammatory drug)/COX-2 inhibitors.
    II.      Anemia due to chronic renal disease.
    III.      Questionable diverticulosis; status post multiple herniorrhaphies; status post- cholecystectomy.
    IV.      Discharge planning: The plan is to discharge the patient to rehabilitation medicine.
    At this time, the patient appears to be stable and is tolerating hemodialysis. We will continue to follow this patient from the renal/hemodialysis standpoint. She will get erythropoietin 10,000 units IV (intravenous) after hemodialysis today.

    Should a modifier be added to the CPT code in order to submit the insurance claim?______________

  10. HEMODIALYSIS PROGRESS NOTE

    LOCATION: Inpatient, Hospital
    PATIENT: Sandra Amada
    ATTENDING PHYSICIAN: George Orbitz, MD

    HEMODIALYSIS PROGRESS NOTE: The patient is seen and examined during hemodialysis. The patient appears to be hemodynamically stable, not in any form of respiratory distress or compromise.

    LABORATORY STUDIES: Latest labs were performed 4 weeks ago. Hemogram shows an H&H (hematocrit and hemoglobin) of 8.6/26.2. WBC (white blood count) is 9.9, normochromic/normocytic indices. Platelets are 143. There is left shift of 81.1% neutrophils. Sodium is 139, potassium 4, chloride 98, CO2 (carbon dioxide) is 30.7, BUN (blood urea nitrogen) and creatinine 31/3.4, glucose 121, and calcium 8.2. Today, we will dialyze her for a total of 4 hours using an HP-150 dialyzer via her right-sided Perm-A-Cath. We will use a 2.0 potassium bath, and we will not give her any heparin loading dose during this treatment.

    PHYSICAL EXAM: At present time, vital signs are stable. Blood pressure is 128/57. Heart rate is 80, and she is tolerating a blood flow rate of 500 ml (milliliter) per minute. Normocephalic and atraumatic. Pale palpebral conjunctivae, anicteric sclerae. No nasal or aural discharge. Moist tongue and buccal mucosa. No pharyngeal hyperemia, congestion, or exudates. Supple neck. No lymphadenopathy. Symmetrical chest. No retractions. Positive rhonchi. No crackles or wheezes. S1 (first heart sound) and S2 (second heart sound) distinct. No S3 (third heart sound) or S4 (fourth heart sound). Regular rate and rhythm. Abdomen: Positive bowel sounds, soft and nontender. No abdominal bruits. Both upper and lower extremities reveal arthritic changes. Pulses are fair.

    ASSESSMENT/PLAN:
    I.      End-stage renal disease (on maintenance hemodialysis, Monday, Wednesday, and Friday), most likely secondary to the following:
    A.      Hypertension. Continue same antihypertensive regimen as ordered.
    B.      Type 2 diabetes mellitus. Continue oral antidiabetic agents. Continue the same dialysis orders as above.
    C.      Previous chronic use of NSAID (nonsteroidal antiinflammatory drug)/COX-2 inhibitors.
    II.      Anemia due to chronic renal disease.
    III.      Questionable diverticulosis; status post multiple herniorrhaphies; status post- cholecystectomy.
    IV.      Discharge planning: The plan is to discharge the patient to rehabilitation medicine.
    At this time, the patient appears to be stable and is tolerating hemodialysis. We will continue to follow this patient from the renal/hemodialysis standpoint. She will get erythropoietin 10,000 units IV (intravenous) after hemodialysis today.

    What claim form will be submitted for the physician’s services? ________________