Nursing

Assignment: The Slippery Slope
Assignment: The Slippery Slope
CASE STUDY
Read the following case study, about the Slippery Slope of Litigating Geologic Hazards at California’s Portuguese Bend. The case study is broken into three parts. After each part, you will answer a few questions related to the reading. Submit a MS Word document or *.pdf file with your responses for each question to the assignment dropbox. All answers should be in your own words (do not copy and paste definitions). Answer each question in at least three complete sentences (upwards of 36-42 words per answer); some answers may require more explanation than others. There ten (10) questions, each question is worth 4 points. You will be deducted points for short and incomplete answers.
PART I. NEWS ARTICLE
Homeowners Allege Negligence (AP) Homeowners in the exclusive Portuguese Bend neighborhood near Long Beach, CA have filed a class action suit in state court against the County of Los Angeles. This suit seeks compensation for damages to 160 homes affected by a landslide encompassing an area of roughly 270 acres. The homeowners allege that this landslide was caused by road construction along Crenshaw Boulevard, a county highway that traverses the northern portion of the slide area. The lawsuit also alleges fraud and negligence on the part of the developers for participating with the county in road construction in a geologically unstable area.
Portuguese Point, most recent times; during sunset. Lizzie McVeigh, (2007), photograph, .
Questions
What is the essence of this article?
What is the scientific basis for the homeowners’ suit?
What information is required to evaluate the scientific basis of this lawsuit?

Analyze a piece of music
Analyze a piece of music
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Analyze a Piece of Music The principles of unity and variety apply to all music, regardless of compositional style or historical period. Now that you are familiar with the concepts in the first section of the course (Basic Musical Concepts), and you have seen how they work on different pieces of music, try your hand, mouse, and ears at how they operate in a music selection that you may not have heard yet: “Manha de Carnaval” by Sigman and Bonfa.
Your analysis should include:
•The number of different musical ideas in the piece (for example, can we say that there are two ideas A and B? Or is there only one?).
•The timings (start and stop times) of the different sections of the piece. (Hint: Listen for changes in musical ideas and timbre, for example, points when different instruments come in or give way to others.).
•How unity and variety are exemplified in those sections through the use of: 1.Dynamics.
2.Timbre.
3.Pitch. .
•Although there are sections that feature one instrument over others, whether you think this is a piece for a solo performer or for an ensemble..
•A list of the characteristics of the musical style closest to the one this piece exemplifies. (Hint: Look at the last lecture in the first section of the course). •Whether you think this piece serves (or could serve) a specific purpose.. •Whether or not it has any specific connotation(s) for you.
Analyze a Piece of Music The principles of unity and variety apply to all music, regardless of compositional style or historical period. Now that you are familiar with the concepts in the first section of the course (Basic Musical Concepts), and you have seen how they work on different pieces of music, try your hand, mouse, and ears at how they operate in a music selection that you may not have heard yet: “Manha de Carnaval” by Sigman and Bonfa.
Your analysis should include:

Assignment: Blurred Boundaries
Assignment: Blurred Boundaries
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Review the Summers text, pp. 136–138. (Use in-text citations and references)
Choose two hypothetical practice situations under “Blurred Boundaries?” You will respond with your two chosen situations and identify what went wrong with the worker-client boundaries AND what needs to happen to correct the situation. Now, imagine that the client was from a culture, background, ethnicity or country very different from your own. Think about how you might respond differently.
Post the number associated with your chosen situation and a brief description. Then answer the following questions: What went wrong with the worker-client boundaries? How might you respond differently (if at all) if the client was from a culture, background, ethnicity or country very different from your own?Please be specific and support your conclusions by citing the course resources AND at least ONE peer-reviewed resource (i.e., journal article, professional organization website, etc.).
Resouces:
Summers, N. (2016). Fundamentals of case management practice: Skills for the human services (5th ed.). Boston, MA: Cengage Learning.Chapter 2, “Ethics and Other Professional Responsibilities for Human Services Workers” (pp. 33–76)Chapter 4, “Cultural Competence” (pp. 95–115)Chapter 5, “Attitudes and Boundaries” (pp. 117–138)
Review the Summers text, pp. 136–138. (Use in-text citations and references)
Choose two hypothetical practice situations under “Blurred Boundaries?” You will respond with your two chosen situations and identify what went wrong with the worker-client boundaries AND what needs to happen to correct the situation. Now, imagine that the client was from a culture, background, ethnicity or country very different from your own. Think about how you might respond differently.
Post the number associated with your chosen situation and a brief description. Then answer the following questions: What went wrong with the worker-client boundaries? How might you respond differently (if at all) if the client was from a culture, background, ethnicity or country very different from your own?Please be specific and support your conclusions by citing the course resources AND at least ONE peer-reviewed resource (i.e., journal article, professional organization website, etc.).
Resouces:
Summers, N. (2016). Fundamentals of case management practice: Skills for the human services (5th ed.). Boston, MA: Cengage Learning.Chapter 2, “Ethics and Other Professional Responsibilities for Human Services Workers” (pp. 33–76)Chapter 4, “Cultural Competence” (pp. 95–115)Chapter 5, “Attitudes and Boundaries” (pp. 117–138)

Discussion: People Who Receive Medicare
Discussion: People Who Receive Medicare
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People who receive Medicare
A. are never eligible to receive Medicaid.
B. may be eligible to receive Medicaid if they meet the age requirement.
C. may be eligible to receive Medicaid coverage.
D. can combine Medicare with TRICARE.
12. Ralph is assigning diagnosis and procedure codes for a 35-year-old patient from New Mexico, who has hypertension and end-stage renal disease. Would this patient qualify for Medicare?
A. Yes, because the patient has end-stage renal disease
B. No, because the patient resides in New Mexico
C. No, because the patient is under age 65
D. Yes, because the patient has hypertension
13. The first prepaid health insurance plans in the United States were
A. TRICARE and workers’ compensation.
B. CHAMPUS and CHAMPVA.
C. Blue Cross and Blue Shield.
D. Medicare and Medicaid.
14. Which of the following is the largest privately underwritten health insurance contract in the world?
A. Harless program
B. SCHIP
C. Federal Employee Program (FEP)
D. CHAMPVA program
15. A provider is classified as a/an
A. biller who submits claims to insurance carriers.
B. coder who provides medical record data.
C. individual or group of individuals that provide a health care service.
D. beneficiary that provides information for insurance coverage.
16. Tom is billing an emergency room visit for a Medicaid patient who’s being seen for a wellness visit. Which one of the following statements is true as a result of the Balanced Budget Act?
A. There are new surgical treatments available.
B. No new applications are required for TAFT recipients.
C. Patients have expanded preventive-care benefits.
D. There are new standards for TRICARE.
17. Dr. Singer is working within a reimbursement system in which the insurance is billed after all the treatment has been given to the patients. What is the main reason that the doctor orders more tests, exams, and procedures under this system?
A. Fear of being sued
B. To increase resource utilization
C. To make a profit
D. Because no one has to pay for it
18. With a PPO, the beneficiary has the ability to
A. choose a hospital within a 50-mile radius only.
B. choose a physician or hospital from the designated provider list.
C. select a dentist within a 10-mile radius.
D. select an add-on policy for supplemental unemployment benefits
19. Physician-hospital organizations (PHOs) are also called _______ organizations.
A. medical staff-hospital
B. health management
C. individual provider
D. preferred provider
20. Mrs. Fang is a 72-year-old retired school teacher who has been hospitalized for pneumonia. What type of insurance is most likely being used to pay for her hospital stay?
A. Medicare Part D
B. Medicare Part B
C. Medicare Part A
D. Medicare Part C

Assignment: Musculoskeletal and Neurologic Disorders
Assignment: Musculoskeletal and Neurologic Disorders
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Discussion: Diagnosis and Management of Musculoskeletal and Neurologic Disorders
Musculoskeletal and neurologic disorders can present complications for pediatric patients from infancy to adolescence. These disorders affect patients physically and emotionally and often impact a patient’s ability to participate in or carry out everyday activities. Patients with these disorders frequently need long-term treatment and care requiring extensive patient management and education plans. Musculoskeletal and neurologic disorders present various symptoms because they affect multiple parts of a patient’s body. Consider treatment, management, and education plans for the patients in the following three case studies.
Case Study 1:
Clay is a 7-year-old male who presents in your office with complaints of right thigh pain and a limp. The pain began approximately 1 week ago and has progressively worsened. There is no history of trauma. Physical examination is negative except for pain with flexion and internal rotation of the right hip and limited abduction of the right hip. Limb lengths are equal.
Case Study 2:
Trevon is an 18-month-old with a 3-day history of upper-respiratory-type symptoms that have progressively worsened over the last 8 hours. His immunizations are up to date. Mom states he spiked a fever to 103.2°F this morning and he has become increasingly fussy. He vomited after drinking a cup of juice this afternoon and has refused PO fluids since then. Pertinent physical exam findings include negative abdominal exam, marked irritability with inconsolable crying, and he cries louder with pupil examination and fights head and neck assessment. You are unable to elicit Kernig’s or Brudzinski’s signs due to patient noncompliance.
Case Study 3:
Molly is a 12-year-old who comes to your office after hitting her head on the ground during a soccer game. Her mother reports that she did not lose consciousness, but that she seems “loopy” and doesn’t remember what happened immediately following her fall. She was injured when she collided with another player and fell backward, striking her head on the ground. She has no vomiting and denies diplopia but complains of significant headache. Physical examination is negative except for the presence of slight nystagmus. All other neurologic findings including fundoscopic examination are normal.
Post at least 200 words (NO introduction or conclusion)
Select one of the three provided case studies.
Provide differential diagnosis for the patient in the case study you selected.
explain the most likely diagnosis for the patient and WHY Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis.
explain treatment and management plan for the patient. including appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
Finally, explain strategies for educating patients and families on the treatment and management of the musculoskeletal or neurologic disorder.

Assignment: Child Development
Assignment: Child Development
Regardless of the career path that you are taking within the field of child development (teacher, parent educator, social worker, child life specialist, early interventionist etc.) you will be working with children and adolescents with disabilities. In this discussion, you will have the opportunity to read two articles that focus on different disabilities and apply your chosen career path to working with children with this disability. First, you will need to choose one of the disabilities below and read both the article in the text (Berk, L. E. (2013).Child development. (9th ed.). Upper Saddle River, NJ: Pearson.) and the PDF Fact Sheet listed for that disability. After reading both of the resources for the document, you will need to address the following IN 3 PARAGRAPHS:
Describe the career path that you plan to take once you have completed your degree.
How will understanding this disability will be crucial to your success in your work with children and their families? Make sure to provide at least two reasons.
What ideas from the two articles will you use to support you in your own practice? For each idea, share an example of how you will implement it.
Disability Article in Text PDF Fact Sheet
Visual impairments Page 162 National Dissemination Center for Children with Disabilities.(November, 2012)..
Brain Plasticity with Brain-Damaged Children Page 188 National Dissemination Center for Children with Disabilities.(October, 2012)..
Speech Delays Page 285 National Dissemination Center for Children with Disabilities.(January, 2011)..
Deaf Children and Language Pages 362-363 National Dissemination Center for Children with Disabilities.(June, 2010)..
Autism Spectrum Disorders Page 457 National Dissemination Center for Children with Disabilities.(June, 2010). .
journal
Mindblindness” and Autism
After reading about Michael, a child with Autism” on page 457 of our textbook,Berk, L. E. (2013).Child development. (9th ed.). Upper Saddle River, NJ: Pearson. and the article , reflect on the following questions:
Do you feel that Autism Spectrum Disorders are due to an impairment in an innate, core brain function or that there is a some kind of intellectual impairment involved? Why?
Also, based on what you read about social stories, do you feel this is a valuable tool for helping children with Autism Spectrum Disorders and possibly other children who are atypically developing socially? Why or why not?

Assignment: Qualities of Leadership
Assignment: Qualities of Leadership
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Question1. Which font is required by APA 6th edition?
Calibri
Arial
Times New Roman
Cambria
Question 2. When is a paraphrase useful?
when you want an alternative to quoting;
when you want to clarify an author’s ideas for the reader and/or for yourself;
when you want to integrate information from charts, graphs, tables, lectures, etc;
all of the above
Question 3. Select the sample below that best demonstrates how to incorporate a citation directly within a sentence for quoted material.
John said, “The research study results were inconclusive” (para. 4).
Smith (2005) stated, “The rules and regulations clearly mandate…” (p. 67).
Marsha (2006) stated, “The financial crisis was a result of bad leadership…”.
Vasquez said in his persuasive documentary, “We will contribute to…” (p. 78).
Question 4. The title page required by Ashford University is a modified version of APA title pages.
True
False
Question 5. Per APA 6th Edition, the acceptable length of an abstract is:
between 150 and 250 words
between 100 and 150 words
at least 200 words
at least 100 words
Question 6. What is the requirement for writing numbers (in APA) for student papers:
Always use figures for numbers
Spell out all numbers above 10
Always spell out all numbers
Always spell out a number in words if it begins a sentence
Question 7. What kind of documents do not usually need headings?
research papers
proposals
short papers that are often read from beginning to end.
reports
Question 8. Every in-text citation needs to be entered in the References list.
True
False
Question 9. Which of the following statements indicates correct usage of a running head and header?
The words “Running head” appear on every page, with the header and page number being listed in the right margin of the title page only.
The words “Running head” are no longer required, but the header and page number are listed in the left margin of every page.
The words “Running head” appear on the title page only, with the header and page number being listed in the right margin of every page.
The words “Running head” appear on the title page only, with the header being listed in the left margin and the page number being listed in the right margin of every page.
Question 10. Select the sample below that best demonstrates how to incorporate a citation directly within a sentence for information that has been summarized or paraphrased.
Adult students are frequently motivated to return to school… (Alex, Marks, & Jones, 2005).
After returning from war (Smith, Peters & Ali, 2007), disabled veterans typically face…
Masters indicated there are no more strategies to be considered for… (1997).
In examining the philosophies of education, the challenges associated with… (Carter & Glick).
Question 11. Written assignments require a separate title page with the following information double-spaced and centered on the page:
Title of the paper, students first and last name, and date submitted
Title of the paper, student’s first and last name, course title, instructor’s name, and date submitted
Title of the paper, student’s first and last name, course title, and date submitted
Title of the paper, students last name, course title, instructor’s name, and date submitted
Question 12. Which is incorrect when creating a References list?
Create a hanging indent for every line after the first in your citation
The word “References” should be centered at the top of the new page and bolded
Alphabetize entries by authors’ last names
Every line should be double spaced
Set 2
Question 1. What kind of documents do not usually need headings?
research papers
proposals
short papers that are often read from beginning to end.
reports
Question 2. Select the sample below that best demonstrates how to incorporate a citation directly within a sentence for quoted material.
John said, “The research study results were inconclusive” (para. 4).
Smith (2005) stated, “The rules and regulations clearly mandate…” (p. 67).
Marsha (2006) stated, “The financial crisis was a result of bad leadership…”.
Vasquez said in his persuasive documentary, “We will contribute to…” (p. 78).
Question 3. Select the item that is true for APA formatted citations.
Include the title of the resource and the author’s name within the parenthetical citation.
Always include the author’s first name or initials in the parenthetical citation.
If no author is listed, then a citation does not need to be included in your paper.
In the absence of a date of publication, write n.d. to indicate no date was provided.
Question 4. Every integrated quotation should have the following:
authors last name, quotation marks, exact date of quote
a signal phrase, the quotation, parenthetical citation
authors last name and date of publication
the authors exact words followed by location of where quote was found
Question 5. When is a paraphrase useful?
when you want an alternative to quoting;
when you want to clarify an author’s ideas for the reader and/or for yourself;
when you want to integrate information from charts, graphs, tables, lectures, etc;
all of the above
Question 6. Every in-text citation needs to be entered in the References list.
True
False
Question 7. Select the sample below that best demonstrates how to incorporate a citation directly within a sentence for information that has been summarized or paraphrased.
Adult students are frequently motivated to return to school… (Alex, Marks, & Jones, 2005).
After returning from war (Smith, Peters & Ali, 2007), disabled veterans typically face…
Masters indicated there are no more strategies to be considered for… (1997).
In examining the philosophies of education, the challenges associated with… (Carter & Glick).
Question 8. Written assignments require a separate title page with the following information double-spaced and centered on the page:
Title of the paper, students first and last name, and date submitted
Title of the paper, student’s first and last name, course title, instructor’s name, and date submitted
Title of the paper, student’s first and last name, course title, and date submitted
Title of the paper, students last name, course title, instructor’s name, and date submitted
Question 9. Per APA 6th Edition, the acceptable length of an abstract is:
between 150 and 250 words
between 100 and 150 words
at least 200 words
at least 100 words
Question 10. For all quoted material, the citation must include:
author(s)’ last name(s), date of publication, and page or paragraph number
author(s)’ last name(s), title of book or website, and page or paragraph number
author(s)’ last name(s), dates of publication, and the title of the source
author(s)’ last name(s), the page or paragraph number, and the section title
Question 11. Citations are used within the body of your paper to indicate information that has come from another source. Select the answer that best describes which information must always be cited within the text:
Quotations, paraphrased, and summarized content
Written or media content that you have paraphrased or summarized
Personal opinions and ideas written in your own words
All of the above
Question 12. Within the body of the text, how many spaces follow a sentence ending punctuation?
one space
two spaces
three spaces
may use one, two, or three spaces; however, spacing must be consistent throughout the document.

Assignment: Interactions of Hazardous Materials
Assignment: Interactions of Hazardous Materials
For this assignment, you are the lead incident commander for a hazardous materials incident similar to those that have been introduced in this course. In this scenario, diisocyanates [toluene diisocyanate (TDI) and methylene diphenyl diisocyanate (MDI)] are being unloaded at the tank farm of HLF Polyurethane Manufacturing. TDI and MDI are used as raw materials in the production of polyurethane. During the unloading process, the vapor return line ruptured and caught fire due to a nearby welding operation that provided the ignition source.
The following actions were initially taken:
The evacuation alarm was sounded and the facility emergency response team (ERT) was activated.
The plant manager and the local fire department were notified of the incident.
The incident command was established at the facility office near the main access gate to the south (this is the furthest distance within the property boundary from the incident location).
The incident commander implemented actions required under the approved emergency response plan.
The ERT was not able to immediately isolate the source of the incident.
The fire department arrived on location and assumed the incident command of the event.
Additional Relevant Information:
The facility encompasses an area measuring 2000 feet by 1400 feet.
The nearest residential community is located approximately 1000 feet to the northeast.
A plastic recycling plant is located along the south fence boundary of the refinery. A major interstate highway runs directly parallel to the plant.
The ambient temperature on the day of the incident was 85° F and the wind was blowing at 7 mph from the southwest to the northeast.
The facility has a trained ERT that can respond to incidents.
Your essay must address the following:
Identify all hazardous materials involved, their classifications and their physical properties.
Discuss chemical incompatibility and interactions relevant to this incident.
Explain how the lead incident commander should respond to this incident based on the Emergency Response Guidebook (ERG).
Click the link below to access the ERG at the Pipeline and Hazardous Materials Safety Administration website: Pipeline and Hazardous Materials Safety Administration. (n.d.). Emergency Response Guidebook (ERG). Retrieved from http://www.phmsa.dot.gov/hazmat/library/erg
Explain the corrective action plan that should be implemented to prevent a reoccurrence of this event.
Your response must be at least one page in length (not counting the cover page or reference page). All sources used, including the textbook, must be referenced. Paraphrased and quoted materials must have accompanying in-text and reference citations in APA format.

Assignment: Incision and drainage
Assignment: Incision and drainage
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Following cases with CPT, ICD-10-CM and/or ICD-9-CM codes:
13 Incision and drainage of deep penis abscess CPT Code: ___________________ ICD-10-CM Code: ________________ (ICD-9-CM Code: __________________)
14 Extensive destruction of penile herpetic vesicle lesions using cryosurgery
CPT Code: ___________________ ICD-10-CM Code: ________________ (ICD-9-CM Code: __________________)
15 Biopsy of kidney with percutaneous incision by trocar for a patient with a diagnosis of microalbuminuria
CPT Code: __________________ ICD-10-CM Code: ________________ (ICD-9-CM Code: __________________)
16 Physician providing the technical and professional component of a cystography with contrast and four views for a patient with hematuria
CPT Codes: ___________________, ___________________
ICD-10-CM Code: ________________ (ICD-9-CM Code: __________________)
17 A one-stage distal hypospadias repair with circumcision and a V-flap for meatal advancement
CPT Code: ___________________ ICD-10-CM Code: ________________ (ICD-9-CM Code: __________________)
18 Needle biopsy with ultrasound guidance of the prostate of an 87-year-old male with an elevated PSA. The pathology results of the biopsy are negative for malignancy.
CPT Codes: ___________________, ___________________
ICD-10-CM Code: ________________
(ICD-9-CM Code: __________________)
19 Dilation with urethral dilator of a urethral stricture of male due to syphilis
CPT Code: ___________________ ICD-10-CM Code: ________________
(ICD-9-CM Codes: __________________, __________________)
20 Injection procedure for Peyronie disease CPT Code: ___________________ ICD-10-CM Code: ________________ (ICD-9-CM Code: ______________
12 Sue Lind, age 29, has a Pap test. The pathology report comes back positive for malignancy. Her physician recommends and performs a diagnostic colposcopy. Evidence of further primary malignancy of the uterus is seen and the physician does a laparoscopically assisted vaginal hysterectomy 20 days later of a 236-gram uterus. Report only the hysterectomy and diagnosis code that indicates the medical necessity of the procedure.
CPT Code: ________________ ICD-10-CM Code: __51925 __________ (ICD-9-CM Code: _____68.3__________)
14 Oocyte retrieval for in vitro fertilization from a donor by means of a follicle puncture with radiologic assistance
CPT Code: ________________ ICD-10-CM Code: ____________ (ICD-9-CM Code: _______________)
16 Colpopexy for displaced uterus using an abdominal approach
CPT Code: ___57280_____________ ICD-10-CM Code: ____________ (ICD-9-CM Code: _______________)
18 Fitting and supply of a diaphragm with instructions for use
CPT Code(s): ________________
20 Using instrumentation, the cervical canal was dilated and examination was completed.
CPT Code: ________________
22. Colpocentesis
CPT Code: ___
Homework#12
Code the following cases using the CPT manual:
11 Total thyroidectomy CPT Code:
12 Surgical laparoscopy with partial adrenalectomy using a transabdominal approach
CPT Code: ____________________
13 Parathyroidectomy with mediastinal exploration
CPT Code: ____________________
14 Stereotactic creation of a thalamus lesion with multiple staging
CPT Code: ____________________
15 Torkildsen type operation with CSF shunt insertion
CPT Code: ____________________
16 Implantation of a tunneled epidural catheter for long-term administration of medication
CPT Code: ____________________
17 Partial resection of a single segment of a vertebral (cervical) body using an anterior approach with decompression of the spinal cord and nerve roots
CPT Code: ____________________
18 Therapeutic injection of the greater occipital nerve with an anesthetic agent
CPT Code: ____________________
19 Complete transection of the facial nerve CPT Code: ____________________
20 Nerve graft of a single strand of nerve, 5 cm in length, to the foot, procedure included procurement of graft
Code the following cases using the CPT, ICD-10-CM and/or ICD-9-CM manuals:
11 Excision of corneal lesion of right eye CPT Code: ____________________
12 Iridectomy with corneal section for removal of lesion from left eye
CPT Code: ___66600-LT_________________
13 Left lamellar keratoplasty with replacement of a thin layer of the cornea with donor cornea
CPT Code(s): ____________________
14 Corneal biopsy of the right eye CPT Code(s): ____________________
15 Diagnostic paracentesis of aqueous in the anterior chamber of the left eye
CPT Code: ____________________
16 A one stage, right eye ECCE with insertion of intraocular lens prosthesis using a manual technique
CPT Code: ____________________
17 A one stage ICCE of the left eye with insertion of intraocular lens prosthesis
CPT Code: ____________________
18 Iridotomy for removal of a primary lesion by means of corneal section, right
CPT Code: ____________________
19 A male patient, age 69, with type 2 diabetes and progressive diabetic retinopathy resulting in retinal hemorrhage. The physician provides three sessions of photocoagulation to his right eye over the course of 2 weeks
CPT Code: ____________________
ICD-10-CM Codes: ____________________,
____________________
(ICD-9-CM Codes: ____________________, ____________________)
20 Repair of a detached right retina by means of an encircling procedure and including scleral dissection, implant, cryotherapy, and drainage of subretinal fluid
CPT Code: ________67107____________ ICD-10-CM Code: ____________________ (ICD-9-CM Code: _______
Homework #13
19 A new patient is seen in the office for unilateral ear pain. In the expanded problem focused history and the physical examination, the physician focuses his attention on the head, ears, nose, and throat. The physician’s provisional diagnoses inc include otalgia andpossible ear infections. The decision making is straightforward for the physician.
CPT Code: ______99241______________
The patient is sent to the clinic’s radiologist for an x-ray of the ear.
CPT Code: ____________________
The patient is then sent to the clinic’s ear specialist, who inserts a ventilation tube (tympanostomy) using local anesthesia.
CPT Code: ____________________ ICD-10-CM Code: ________________ (ICD-9-CM Code: ____________________)
20 A new patient is seen in the office for a variety of complaints, but in particular a swelling and heaviness of his right leg. The physician documents the patient’s complaints, collects a comprehensive history of the present illness, performs a comprehensive review of systems, and inquires about the patient’s past, family, and social history. A complete multisystem physical examination is performed. The physician’s working diagnosis is edema of
the lower extremity, cause to be determined. Given the nature of the problem, the physician
considers the decision-making process to be highly complex.
CPT Code: ____________________ ICD-10-CM Code: ________________ (ICD-9-CM Code: ____________________)
21A The patient is sent to radiology for a unilateral lymphangiography of one extremity due to swelling of the arm. The patient has a history of breast cancer.
CPT Code: ____________________
ICD-10-CM Codes: ________________, ________________ (ICD-9-CM Codes: ____________________, ____________________)
21B Another physician performs the injection procedure for the lymphangiography.
CPT Code: ____________________
ICD-10-CM Codes: ________________, ________________ (ICD-9-CM Codes: ____________
6. The Hematology and Coagulation subsections contain codes based on the various testing methods and tests. The method used to do the test is often the code determiner. Blood cell counts can be manual or automated,
with many variations of the tests. What would the code be for an automated blood count (hemogram) with automated differential WBC count? A manual blood count (hemogram) with manual cell count?
Automated CPT Code: ___________________
ManualCPTCode:____________3___________ Code the following three cases with the correct
pathology code from the CPT:
7 The specimen is tonsils and adenoids. The procedure is a tonsillectomy with adenoidectomy.
CPT Code(s): ___________________
8 The specimen is an appendix. The procedure is an incidental appendectomy.
CPT Code(s): ___________________
9 The specimen is a tooth. The procedure is an odontectomy, gross examination only.
CPT Code(s): ___________________
Code the following:
10 Western Blot of blood, with interpretation and report
CPT Code(s): ___________________
11 Vitamin K analysis of blood CPT Code(s): ___________________
12 Quantitative analysis of urine for alkaloids CPT Code(s): ___________________
13 Three specimens of gastric secretions for total gastric acid
CPT Code(s): ___________________
14 Blood analysis for HGH CPT Code(s): ___________________
15 Total insulin CPT Code(s): ___________________
16 LDL cholesterol using direct measurements CPT Code(s): ___________________
17 Blood count (leukocyte only): one manual cell count
CPT Code(s): ___________________
18 Blood smear interpretation CPT Code(s): ___________________
19 PTT of whole blood CPT Code(s): ___________________
20 Sedimentation rate, automated for fever and swelling in hand
CPT Code(s): ___________________
ICD-10-CM Code(s): ________________ ICD-9-CM Code(s): ___________________)
( 21 Lee and White coagulation time
CPT Code(s): ___________________
22 Clotting factor XII (Hageman factor) for excessive bleeding menopausal onset
CPT Code(s): ___________________
ICD-10-CM Code(s): ________________ ( ICD-9-CM Code(s): ___________________)
23 Blood typing for paternity test, ABO, Rh, and MN
CPT Code(s): ___________________
24 Culture of urine for bacteria with colony count for pain on urination
25 Schlichter test for complaints of leg pain and fever CPT Code(s): ___________________
ICD-10-CM Code(s): ________________ ICD-9-CM Code(s): ___________________
CPT Code(s): ___________________
27 Therapeutic drug assay for digoxin and vancomycin, patient has chronic sinus bradycardia
CPT Code(s): ___________________
(
ICD-10-CM Code(s): ________________ ICD-9-CM Code(s): ___________________)
ICD-10-CM Code(s): ________________ ICD-9-CM Code(s): ___________________)
26 Postmortem examination, gross only, with brain and spinal cord
CPT Code(s): ___________________
( 28 Pathology consultation during surgery
CPT Code(s): _____

Assignment: Nursing Health Reform
Assignment: Nursing Health Reform
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The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March of 2010. Identify the impact of this legislation on your nursing practice by choosing two key nursing provisions outlined in the topic material “Nursing and Health Reform.”
Discuss how these two provisions have impacted, or will impact, your current practice of nursing.
Nursing and Health Reform
The Patient Protection and Affordable Care Act (PPACA) was signed into law by President Obama on March 23, 2010. This law will enact sweeping changes to almost every facet of the health care system over the next ten years. The law makes changes that will impact providers, insurers, consumers, Medicare & Medicaid, and payment policies. For the purposes of this document we wanted to provide readers with an overview of those provisions in the new law that will impact the nursing community as well as their facilities. This article is intended to provide an overview of those sections of the law most relevant to WOCN members. The information focuses on three main aspects of the law: nursing workforce provisions, payment reform provisions, and facility specific provisions. Each provision is given a brief summary and policy goal of the language contained in the law. Readers can find the full legislative language for each section here: http://www.gpo.gov/fdsys/pkg/PLAW111publ148/html/PLAW-111publ148.htm Nursing Workforce Provisions Policy makers recognized the need for an increased workforce to care for the millions of consumers who would be added to the ranks of the insured under PPACA. This — in conjunction with an already existing workforce shortage within the nursing community — led to a number of provisions designed to increase the number of nurses in the coming years. Those provisions are as follows: Section 5202 Nursing student loan program—Updates the loan amounts for the Nursing Student Loan program and after 2012 the Secretary (of the Department of Health and Human Services) has discretion to adjust this amount based on cost of attendance increases.
Assignment: Nursing Health Reform
Section 5203 Health care workforce loan repayment programs—Establishes a loan repayment program for individuals who are willing to practice in a pediatric medical or surgical subspecialty or in a child mental or behavioral health care for at least 2 years in an underserved area. Recipients, which include psychiatric nurses, social workers, and professional/school counselors, are eligible to receive $35,000/year in loan repayments for participation in an accredited pediatric specialty residency or fellowship. HHS is to give priority to applicants who are or will be working in a school setting, have familiarity with evidence-based healthcare, and can demonstrate financial need. Section 5204 Public health workforce recruitment and retention programs—Establishes Public Health Workforce Loan Repayment Program to assure an adequate supply of public health professionals to eliminate workforce shortages in public health agencies. HHS will repay up to 1/3 of loans incurred by a public health or health professions student in exchange for an agreement to accept employment with a public health agency for at least three years. Those serving in priority service areas may qualify for additional loan repayment incentives at department’s discretion. Section 5205 Allied health workforce recruitment and retention programs—Authorizes an Allied Health Loan Forgiveness Program to assure there is an adequate supply of allied health professionals to eliminate workforce shortages at public health agencies, acute care facilities, ambulatory care facilities, and other underserved health facilities. Section 5206 Grants for State and local programs—Authorizes HHS to make grants to accredited educational institutions that support scholarships for mid-career public health and allied health professionals who seek additional training in their respective fields. Section 5207 Funding for National Health Service Corps—Increasing funding for National Health Service Corps (NHSC) and extends authorization of appropriations for the Corps thru 2015. For FY2016 and beyond, a formula for funding is established to tie increased costs in healthcare to the number of individuals residing in health professions shortage areas. Section 5209 Elimination of cap on commissioned corps—Removes cap of 2800 commissioned officers in National Health Services Corps regular corps. Section 5210 Establishing a Ready Reserve Corps—Reconstitutes the Public Health Service Corps into the commissioned Regular Corps and a Ready Reserve Corps for service in time of national emergencies. Section 5301 Training in family medicine, general internal medicine, general pediatrics, and physician assistantship—Establishes a grant program for hospitals, medical schools, academically and affiliated PA training programs to develop and operate accredited training programs for the provision of primary care. Section 5302 Training opportunities for direct care workers—Establishes a 3 year grant program under which an institution of higher education can subsidize training of individuals at that institution who are willing to serve as direct care workers in a long-term or chronic care setting for at least two years after completion of their training. Section 5305 Geriatric education and training; career awards; comprehensive geriatric education—Authorizes HHS to award grants to advanced practice nurses who are pursuing a doctorate or other advanced degree in geriatrics and who, as a condition of accepting a grant, will agree to teach or practice in the field of geriatrics, long-term care, or chronic care management for a minimum of 5 years. Section 5309 Nurse education, practice, and retention grants—Adds 2 new grant programs specifically focused on nurse retention. One will authorize HHS to award grants to accredited nursing schools or health facilities to promote career advancement among nurses.
Assignment: Nursing Health Reform
The 2nd will permit HHS to make awards to nursing schools or health facilities that can demonstrate enhanced collaboration and communication among nurses and other health care professionals. Priority directed towards applicants that have not previously received an award. Section 5310 Loan repayment and scholarship program—Expands Nurse Loan Repayment and Scholarship Programs to provide loan repayment for students who serve for at least two years as a faculty member at an accredited nursing school. Section 5311 Nurse faculty loan program—Increases the Nurse Faculty Loan Program amounts from $30,000 to $35,000 in FY 2010 and FY 2011, declares that the amount of these loans will thereafter be adjusted to provide for cost-of-attendance increases for yearly loan rates and the aggregate loan. Creates new authority to permit HHS to enter into an agreement with individuals who hold unencumbered RNs and who have already completed, or are currently enrolled in, a master’s or doctorate training program for nursing. HHS will provide up to $10,000/year to master’s recipients and $20,000/year to those who earn a doctorate so long as these individuals spend at least 4 years out of a 6 year period as a full-time faculty member at an accredited nursing school. Section 5312 Authorization of appropriations for parts B through D of title VIII— Authorizes $338 million in appropriations to carry out nursing workforce development programs in FY 2010. FY 2011-2016 will be funded according to what HHS determines as “such sums as may be necessary” to carry out these programs. Section 5404 Workforce diversity grants—Expands the workforce diversity grant programs by permitting such grants to be used for diploma and associate degree nurses to enter bridge or degree completion programs or for student scholarships and stipend programs for accelerated nursing degree programs, This statute instructs HHS to consider recommendations from the National Advisory Council on Nurse Education and Practice and to consult with nursing associations. Section 5507 Demonstration projects to address health professions workforce needs; extension of family-to-family health information centers—Establishes a demonstration grant program to provide educational and training opportunities for low-income individuals for positions in the healthcare field that pay well and are expected to be in high demand. Program will primarily serve State TANF recipients, but HHS required to award at least 3 demonstration grants to eligible entities that are Indian Tribes, tribal organizations or Tribal colleges and Universities. Section 5509 Graduate nurse education demonstration—Appropriates $50 million/year FY 2012 thru FY 2015 to establish a graduate nurse education demonstration program in Medicare. Hospitals selected will be reimbursed for educational and clinical instruction costs attributed to training advanced practice nurses to provide primary/preventive care, translational care, chronic care management, as well as any other nursing services appropriate for the Medicare eligible population. Those hospitals selected will partner with community based care settings and accredited nursing schools to undertake the demonstration program and will reimburse partners for their share of costs. Section 10501—Permits faculty at public health schools that offer PA education programs to obtain faculty loan repayment under the workforce diversity program. Also makes other improvements to the NHSC program, such as a provision to increase the loan repayment amount, allowing half-time service and permitting teaching to count for as much as 20% of the service commitment to the NHSC. Pilot and Incentive Payment Program Provisions: In addition to policies aimed at increasing the number of nurses, policy makers also sought to more closely integrate nursing into new payment pilot programs that would offer incentives to primary and chronic care managements as well as provide alternatives to the current fee-forservice programs. Payment revisions are as follows: Section 2703 State option to provide health homes for enrollees with chronic conditions— Creates a state option under Medicaid to provide coordinated care through a “health home” for individuals afflicted with chronic conditions. States could receive 90 percent of the funding needed to support Medicaid enrollees who designate a provider or team of medical professionals as their health home through Federal Medical Assistance Percentages (FMAP). Section 3022 Medicare shared savings program—Establishes a shared savings program under which a group of providers and suppliers may form a legally structured Accountable Care Organization (ACO) to manage and coordinate care for Medicare fee for service beneficiaries. Section 3024 Independence at home demonstration program—Creates the Independence at Home demonstration program for chronically ill Medicare beneficiaries in order to test a payment incentive and service delivery system that would utilize physician and nurse practitioner directed, home-based primary care teams with the aim of reducing expenditures and improving health outcomes. Section 3501 Health care delivery system research; Quality improvement technical assistance—Establishes a Center for Quality Improvement and Patient Safety within the Agency for Healthcare Research and Quality (AHRQ). This center will support the identification of best practices for quality improvement in the delivery of health care services by identifying healthcare providers that employ best practices and finding ways to translate these practices rapidly and effectively into practice elsewhere. The Center will establish a Quality Improvement Network Research Program to support research on healthcare delivery system improvement. The Director of AHRQ, under this section, will also be directed to award technical assistance grants to struggling healthcare providers to aid in the implementation and adoption of best practices identified by the Center. Section 3502 Establishing community health teams to support the patient- centered medical home—Authorizes HHS to establish a grant program for states/state designated entities to establish community-based interdisciplinary, interprofessional teams to support primary care practices within a certain area. Health teams must support patient-centered medical homes, defined as a mode of care that includes personal physicians, whole person orientation, coordinated and integrated care and evidence-informed medicine.
Assignment: Nursing Health Reform
Section 5208 Nurse-managed health clinics—Authorizes $50 million in grants for the cost of operation of Nurse-Managed Health Clinics (NHMC) that provide comprehensive primary care or wellness services without regard to income or insurance status of patients. NHMCs must provide care to underserved or vulnerable populations and be associated with an academic department of nursing, qualified health center or independent nonprofit health or social services agency. Also establishes a new program to support nurse-managed health centers, authorizes to be appropriated $50 million for FY 2010 and such sums as may be necessary for FY 2011-2014. Section 6301 Patient-Centered Outcomes Research—Establishes non-profit Patient Centered Outcomes Research Institute. Purpose of Institute will be to assist patients, physicians, purchasers and policy-makers in making informed health decisions. Facility Specific Provisions Finally, PPACA makes facility specific changes including provisions directly impacting hospice and palliative care facilities, those provision follow: Sections 6101-6121—Require Medicare Skilled Nursing Facilities (SNFs) and Medicaid nursing facilities to disclose information on their ownership and organizational structure to government authorities. Mandates that such facilities implement compliance and ethics program within 3 years of enactment. Section 6103 directs the Nursing Home Compare Medicare Website to release staffing data for each facility, including resident census data, hours of care provided per resident per day, staffing turnover and tenure. Section 6105 directs the Secretary to create a standardized complaint form and requires states to establish a complaint resolution process, as well as providing whistleblower protection. Both provisions are effective within 1 year of enactment. Section 3004 Quality reporting for long-term care hospitals, inpatient rehabilitation hospitals, and hospice programs—Requires quality reporting programs for long?term care hospitals, inpatient rehabilitation facilities, and hospice providers in 2014. HHS must issue regulations by October 1, 2012 that will list the specific quality reporting measures that must be reported. Providers who do not participate in the program would be subject to a reduction in their annual market basket update. Section 10325 Revision To Skilled Nursing Facility Prospective Payment System—Delays implementation of certain skilled nursing facility Version 4 of the Resource Utilization Groups (RUG-IV) published in the Federal Register on August 11, 2009 payment system changes by one year to October 1, 2011. Section 10326 Pilot Testing Pay-for-Performance Programs for Certain Medicare Providers—Directs HHS to conduct a separate pilot program under Medicare to test the implementation of a value-based purchasing program for payments under such title for the following provider groups: Psychiatric hospitals, Long-term care hospitals, Rehabilitation hospitals, PPS-exempt cancer hospitals and Hospice programs.