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MDC11 腎及泌尿道疾病

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 :

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MDC11 腎及泌尿道疾病

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  1. MDC11腎及泌尿道疾病 黃素勤 96/06/22

  2. 習題演練

  3. 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

  4. 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 RW差 -1.1955

  5. 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

  6. 解答 • 代碼: • 診斷碼:592.1+591+038.42+599.0 • 處置碼:56.0+56.0+59.8+59.8 • MDC 11 • DRG 310(經由尿逆道之手術有合併症或併發症)

  7. 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

  8. 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 catheterfor dialysis 2.H/D

  9. 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

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