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MDC11腎及泌尿道疾病 黃素勤 96/06/22
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習題演練
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例題一 出院診斷: 1.ESRD on HD with Acute pulmonary edema 2.HCVD
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
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解答 編法二: 404.92+518.4+39.95 MDC :11 DRG:31601 幾何平均住院日： 編法一： 7天
MDC :4 DRG:0.9405 幾何平均住院日： ５天 RW：0.4763 編法二: MDC :11 DRG:31601 幾何平均住院日： 7天 RW：1.6718 RW差
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例題二 出院診斷： 1.bilateral lower ureteral stone 2.bilateral hydronephrosis
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
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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)
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解答 Stone ureter 592.0 hydronephrosis 591
Septicemia with Escherichia coli Infection urinary Removal ureter without incision Insertion ureteral stent 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
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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
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解答 代碼: 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 診斷碼:
處置碼: 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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