#47 Which is a predetermined payment amount for all services provided during an episode-of-care?

a. capitation

b. case rate

c. bundled payment

d. global payment

Which refers to the kind of health care services provided to patients?

a. level of service

b. type of service

C. concurrent care

d. transfer of care

Apply the ICD-10-CM Official Guidelines for Coding and Reporting of the Principal Diagnosis for Inpatient Care (Guidelines I A- J) to identify the principal diagnosis in the following scenario.

The patient was admitted to the hospital for a total right knee replacement for osteoarthritis of the knee. During the patient's preoperative preparation, the patient began having chest pain. The patient's knee surgery was canceled, and the patient had extensive testing to determine the source of the chest pain, which was determined to be due to hypertensive heart disease.

Jennifer Williams is a 43-year-old recently divorced female who has two teenage daughters aged 18 and
16 years. Her 16-year old daughter is 7 months pregnant. Jennifer's ex-husband is an alcoholic and is
involved with her daughters but cannot be relied on for financial assistance. She lives in an older home
in a low-income neighborhood. Her aging and widowed mother, who lives a few blocks away, is in the
early stages of Alzheimer's disease and needs regular assistance. Ms. Williams is the main caregiver for
her mother. She is employed full-time as an office assistant and regularly has difficulty making ends
meet financially.

A number of recent events have been challenging for Jennifer. Her pregnant daughter recently broke up
with her boyfriend and Jennifer knows she will be largely supporting and raising her grandchild. She also
recently had an intense argument with her oldest daughter about attending college—something she
supports but can't afford. In addition to all of these issues, Jennifer's mother fell and broke her arm. She
is now trying to meet the increasing care her mother needs.

All these events have been weighing heavily on Jennifer's mind. She is feeling highly anxious and is
experiencing difficulty sleeping. She has had intermittent diarrhea and has become highly irritable,
leading to arguments at work with her coworkers. Jennifer also began experiencing headaches. Fearing
she had something seriously wrong with her, she went to an urgent care clinic. After a brief visit focusing
on her headache, she was told not to worry because she was “only experiencing a tension headache”
and was a little hypertensive, and she was advised to see her primary care physician. Jennifer was
relieved to learn she did not have a brain tumor, but she has no intention of seeing another physician for
the headaches. She does not want to spend any more money on herself.

        ZOOM         Case Analysis Template:
Select your case and use this format to analyze the important Concepts you identify.
Remember, there are likely more than 3, but use 3 as your maximum.
1.) Identify relevant data from the present problem/ situation:
- Summarize the current situation and factors
2.) Personal/ Social history:
- Summarize: familial, occupational, and recreational aspects of the patient's personal life
that have the potential to be clinically significant.
3.) What are the interrelated Concepts for this case that you have identified and choose to
focus your paper? Discuss the principles within the Concept/s selected, apply those
principles to the case.
Ex/ Adherence Case and Class Activity Example
1) Adherence
2) Health Promotion
3) Patient Education
4.) Bring in a research article to further support your case, how can the research support further
investigation of the concepts you are looking at, how as a nurse can the research help you
support (ie. Education, collaboration, communication) a patient/ family.
5.) Conclusion: What outcomes would be important to include for this patient/ case?
What is your conclusion (wrap -up) and key elements of the case?