Dysphagia pharyngoesophageal - Risks and benefits of upper endoscopy with percutaneous gastrostomy tube placement discussed with patient[] including bleeding, infection, perforation with injury to other organs, and death. Patient[] agreeable to proceed with upper endoscopy with PEG tube placement.
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sessile serrated polyp with dysplasia - colonoscopy for surveillance in 3 years. sessile serrated polyps < 1 cm without dysplasia -colonoscopy in 5 years. piecemeal resection of a 1 cm colorectal adenoma - colonoscopy in 2 to 6 months would be indicated after. sessile serrated polyposis syndrome - colonoscopy in 1 year.
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TIPS procedure for cirrhosis. Study - Symptomatic Heart Failure After Transjugular Intrahepatic Portosystemic Shunt Placement: Incidence, Outcomes, and Predictors. Results - 883 patients underwent TIPS, eight (0.9%) patients developed SHF, hypoxemia (50%) or dyspnea (25%) within 48 hours.
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Dysphagia esophagopharyngeal - foreign body in esophagus, food impaction. Differential diagnosis includes Schatzki ring, achalasia, esophageal stricture, eosinophilic esophagitis and less likely esophageal cancer. Risks/benefits of upper endoscopy with foreign body removal discussed with patient[] including bleeding, infection, perforation, and death. Patient agreeable to proceed with upper endoscopy.
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ICD 10 Diagnosis for Gastroenterology. Inpatient Gastroenterology. Hematemesis, hematochezia, melena, acute blood loss anemia, elevated liver enzymes, dysphagia esophagopharyngeal, epigastric abdominal pain, right upper quadrant abdominal pain, left upper quadrant abdominal pain, right lower quadrant abdominal pain, abnormal CT, ascites, hepatic encephalopathy, alcoholic cirrhosis, non-alcoholic cirrhosis, C. difficile diarrhea, acute pancreatitis, chronic pancreatitis, biliary pancreatitis, cannabis hyperemesis syndrome, cyclic vomiting syndrome, abnormal intraoperative cholangiogram.
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[] year old presents with dysphagia to []solids []liquids for [] months. Points to []xyhpoid. [] weight loss.
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HPI: 58 year old male with intermittent chest pain
Past Medical History: Diabetes mellitus, high cholesterol, obesity, hypertension, cholecystectomy
Medications: Lantus, lisinopril, lipitor
Allergies:
Family History: Brother with colon cancer
Social History: 1 pack of tobacco per day
Review of Systems: intermittent dyspnea
Physical Exam: normal
Labs/Radiology/Procedures: Total cholesterol 230
Assessment/Plan: EKG, troponin, stress test, possible cardiac cath. Consult cardiologist.
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Dysphagia pharyngoesophageal - Risks and benefits of upper endoscopy with percutaneous gastrostomy tube placement discussed with patient[] including bleeding, infection, perforation with injury to other organs, and death. Patient[] agreeable to proceed with upper endoscopy with PEG tube placement.
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Prior authorization by an insurance company for an EGD requires four weeks of proton pump inhibitor therapy. 2022.
Esophagogastroduodenoscopy (EGD) Section(s): EGD 1.1: Dyspepsia/Upper
Abdominal Symptoms, we cannot approve this request. Your records show that
your doctor wants to check you for disease in your stomach. The request
cannot be approved because:
The requested test or one like it may be supported for one of the
following reasons.
-You are 60 years of age or older.
-A person related to you has had serious disease in the stomach or the
tube in your throat that leads to your stomach.
-You have lost weight (more than five percent) without trying.
-You have blood in your stool or vomit.
-You have trouble swallowing.
-You have a hoarse voice.
-You have vomiting that does not stop.
-Results of a prior study were not normal.
-You did not improve following a trial of at least four weeks of treatment.
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ICD 10 codes Dysphagia R13.10 || K92. 1: Melena. || Hematochezia K62.5 || Abnormal abdominal ct scan R93.5 #gastro
#gastro
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