CC: Patient is here to discuss catapress Rx and also patient…
Questions
CC: Pаtient is here tо discuss cаtаpress Rx and alsо patient has a nоnproductive cough, nasal drainage and sinus congestion/pressure. Symptoms for a few days. Subjective HPI: She is back on her Catapress patch and doing well Earwax, used Debrox Cough, wheezing and nasal congestion for a few days ROS: Time Spent: 0:00:53 Start Stop Reset Constitutional: Denies symptoms other than stated above. ENMT: Denies ENMT symptoms other than stated above. Cardiovascular: Denies chest pain, edema and palpitations. Respiratory: Denies symptoms other than stated above. Gastrointestinal: Denies gastrointestinal symptoms. Genitourinary: Denies urinary symptoms. Psych: Stable w/o acute changes. Current Meds: Lancets, Onetouch Test Strips, Citalopram Hydrobromide 40 mg, Simvastatin 40 mg, Glipizide 10 mg, Metformin HCL 1000 mg, Benztropine Mesylate 1 mg, One Touch Glucose Monitor, Catapres-TTS- 1 0.1 mg/24hr Allergies: NKDA Social History: Marital status: Single. Lives in an assisted living facility. Personal Habits: Cigarette Use: None. Alcohol: Denies alcohol use. Drug Use: Denies Drug Use. Daily Caffeine: Consumes on average 4 sodas per day. Reviewed, no changes. Objective BP: 124/72. Pulse: 88. T: 97.7. RR: 20. HT: 63" 5'3", WT: 2091b Constitutional: No signs of apparent distress present. ENMT: Tympanic membranes: not visible due to impacted cerumen. Congestion of the nasal mucosae. Posterior pharynx is normal. Neck: Palpation reveals no lymphadenopathy. Thyroid exhibits no thyromegaly. No JVD. Respiratory: Respiration rate is normal. Auscultate good airflow. Mild expiratory wheezes appreciated over the lungs bilaterally. CV: Rate is regular. Rhythm is regular. No heart murmur appreciated. Extremities: No clubbing, cyanosis or edema. Abdomen: Abdomen Is Benign. Musculoskeletal: Walks with a normal gait. Skin: Skin is warm and dry. Psych: Patient's attitude is cooperative. No apparent anxiety, depression, or agitation. Patient shows good eye contact. Patient had increased cough response with attempted irrigation which subsided immediately. Assessment #1: J06.9 URI Upper Respiratory Infections Acute Unspecified Sites Plan for #1: Med Current: Zithromax Z-Pak 250 mg as directed Proventil HFA108 mcg/act 2 puff q 4h pm Assessment #2: E11.9 Diabetes Mellitus W/O Complication Type II or Unspecified Controlled Plan for #2: Med Current: Glipizide 10 mg 1 po bid Metformin HCL 1000 mg 1 po bid Lab: Diabetic Panel Follow-up: after lab work Assessment #3: H61.23 Impacted Cerumen Plan for #3: Referral: ENT referral After the coder reviews the documentation, which codes are recommended to be reported that will affect the HCC risk adjustment value? I. J06.9 II. E11.9 III. H61.23
Whаt dоes the filtrаtiоn membrаne in the glоmerulus allow to pass?