unsure of diagnosis - ripping my hair out

My question is about headings. Is it principle diagnosis or principal diagnosis? I have typed it "principle" for 10 years. The person doing our QA says it is principal. Has this changed? thanks ...

I am very interested in taking the classes for coding and billing. Has anyone taken the inpatient and outpatient classes that Career Step offers? If so, can you share any pros or cons about the program. I am also considering another online coding and billing course through Gatlin University, but I am not sure if they offer both inpatient and outpatient coding. Has anyone taken that program and can you share your pros and cons here too. Thank you :) ...

I want to work outside my home, get an hourly clinic job, but I have worked at MQ/MM for so long now in my house...I am nervous about going back into an office setting. I'm so comfortable here with my heating pad, getting up when I want to, not dressing up. Do you have any encouragement for me? I want to earn more money, because this is pitiful. It just kind of scares me. ...

There is no family history of any kind of clotting disorders, bleeding disorders, s/l "hemo celia", anemia, s/l thala cemere", or any other hematological disorders or malignancies. I don't know if hemocele is right s/l "hemocelia" and I don't know and can't find if it is standalone or hemocele anemia??? any help much appreciated! ...

I am usure as to where one thought ends and the next begins as in the part of plantar flexion in the toe at teh extremes....something just does not seem like I have the sentences correct. Any idea what I am doing wrong? tia. Evaluation of the foot does show dorsomedial bony prominence that is tender to palpation. There is also pain with passive dorsiflexion and plantar flexion in the toe at the extremes. She is stiff as compared to the contralateral side. ...

Laboratory studies ordered today include Chem 10, PTH 125 25, and urine calcium/creatinine. is this right for chem 10 and unsure of the PTH 125 25 - how to type. thanks! ...

unsure of punctuation and also the last sentence. I typed all as dictated, but think there should be a comma after femur, and no fractures noted as a separate sentence. Any ideas? tia. X-rays of the pelvis and hip show some degenerative changes in the right hip greater than the left with narrowing of the joint space and osteophyte formation around the head of the femur. The greater trochanter and intertrochanteric area no fractures are noted. ...

type the way it is dictated. The doctor states the patient will receive a gram of s/l incif preoperatively. tia. unsure if I would type it as A GRAM of ____ . TIA. ...

There is some weakness and tenderness in the supraspinatus portion of the rotator cuff. She also has s/l with some___ inferior traction a catching sensation over the inferior aspect of her shoulder the glenohumeral joint. She also gets this too from a neutral to an abducted position of the shoulder. the s/l sounds like with some and the rest of the sentence doesn't seem to fit correctly. Something seems to be missing even though I typed exaclty what the doctor said. tia ...

What would be the difference in being a coder in a physician's clinic, insurance company, mental health facility or home health facility. Which setting would provide the most interesting work, the easiest, the least time-consuming? ...

I have a doctor that says his meds rather quickly, without pause.... He says this frequently and I truly do not know if it is 2 meds or one.... we have to separate our medications into numerical order. "Glucose and glucagon prn sliding scale insulin" Any help greatly appreciated. ...

doc states: pt reports photosensitivity when taking s/l NEGRAM or any GRAM. not sure if she is saying NEGRAM or any GRAM. ...

per audio hour of dictation? A company wants me to quote this fee to them and I have never calculated this as I usually charge by line or page, etc. Thanks for any and all advice! ...

The patient is now 1 week postoperative arthroscopy and debridement of the right knee. Findings revealed a medial plica, chondromalacia patella, trochlear notch of the femur, and an anterior synovectomy. All of these were débrided. I am unsure this is correct even though it is said clearly. This is a procedure not a finding and that is why I am very unsure. TIA. ...

A prescription of OxyContin 10 mg 1 p.o. q.12h. X #14 and Percocet 10/325 1-2 p.o. q.4-6 hours #40 was prescribed to the patient. TIA. ...

Hi. I wanted to post this here because I need to get some feedback to my situation. I have been an MT over 20 years. About 2 years ago, I went through a divorce and became self-supporting. It took me until now to get a full-time job editing where I have enough work to keep me without NJA. The last 1-1/2 years I saw such poverty, I lost my car, my home and got lots of help from Salvation Army while working 2 MT jobs which barely kept me alive. I worked for on ...

I don't know if I am just not thinking straight or if there is reason I cannot find these. Under diagnoses, doc says the pt has ARA(?), DM, car-pul-mon-ali, P slash atrial fibrillation.... Seriously, I cannot find ARA, no sign of carpulmonali, or P/atrial fibillation. Any ideas at all? I am going to continue to think and search. TIA for any help! ...

Degenerative lateral meniscus tear? It sounds like he is saying degenerative. I have not heard of "degenerative" lateral meniscus tear. tia. ...

LEFT SHOULDER STRAIN CERVICAL AND TRAPEZIUS MYALGIA If so, would there be a comma put in? TIA. ...

s/l hypergolactanemia. The patient is on s/l promaxitine. ...

1. AIDS 2. Meningitis versus AIDS "sulfa patty"? ...

Urogenital Distress Inventory is the urologic term I know but this is listed as a diagnosis and has to be written out naturally. Anyone know it? Thanks. ...

If "elevated INR" is listed in the diagnosis, would INR be expanded to international normalized ratio? Thanks!! ...

I need to expand it, so would I type human leukocyte antigen B27, or do I need to put a hyphen in it? ...

would this be one or two? tia. DIAGNOSIS: STATUS POST CHEVRON BUNIONECTOMY, FOURTH HAMMERTOE CORRECTION ...

DIAGNOSES: 1. LEFT ANKLE SPRAIN 2. POSTERIOR TIBIAL TENDINOPATHY tia. ...

Axis III diagnosis, sounds like: History of left "corioma" of uncertain clinical significance. any help is appreciated. ...

Crush injury, right foot fracture of metatarsals tia. ...

When did this become okay? I got called on my last QA that spelling out CVA or MI in the diagnosis is a no-no. ...

unsure of diagnosis - ripping my hair out

The with could be and, it would make sense then. - NM

Thank you. - ripping my hair out

ripping my hair out - Makes sense to me

Diagnosis - KM

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