A 60-year-old female patient is brought to a small community hospital complaining of flank and back pain, fever with chills, fatigue, and a general ill feeling.

A 60-year-old female patient is brought to a small community hospital complaining of flank and back pain, fever with chills, fatigue, and a general ill feeling. The patient was known to have essential hypertension and had a history of renal calculi treated six months ago. The patient was admitted with the diagnosis of possible urinary tract infection. Workup in the hospital showed evidence of acute pyelonephritis. She was treated with intravenous antibiotics, but while in the hospital the patient had a sudden loss of kidney function. A diagnosis was made of acute renal failure complicating the acute pyelonephritis. The physicians were concerned that the patient may need kidney dialysis, but this small community hospital did not have the equipment for dialysis. A urinary catheter was placed in the bladder, and a transfer of the patient to a larger hospital in the same city was quickly accomplished.

Question 1: Identify the principal diagnosis and list the appropriate code and include the appropriate POA status indicator.

Question 2: Explain your rationale for selecting the principal dx.

Question 3: Identify any secondary diagnoses and list the appropriate code(s) and include all appropriate POA status indicators for each code.

Question 4: Explain your rationale for selecting secondary diagnoses and the sequencing of these codes

Question 5: Identify the principal procedure and list the appropriate code.

Question 6: Explain your rationale for selecting the principal px.

Question 7: Identify any secondary procedures and list the appropriate code(s).

Question 8: Explain your rationale for selecting the secondary procedures and the sequencing of these codes.

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