README.md

metadata

title: AI ChatGPT EACN
emoji: 🏃
colorFrom: yellow
colorTo: yellow
sdk: streamlit
sdk_version: 1.19.0
app_file: app.py
pinned: false
license: mit
duplicated_from: awacke1/AI-ChatGPT-CPT-Body-Map-Cost

EACN - EDI, ADT, CCD, Note

EDI Sample with All DX and Services

EDI:

ISA00 00 ZZEMRSENDER ZZRECEIVER 2305041345^005010000000010P:~ GSHSEMRSENDERRECEIVER2023050413451X005010X221A1~ ST2780001~ BHT007811100012345202305041345~ HL1201~ NM1X32RECEIVER***46123456789~ HL21211~ NM11P2DOEJANE*46987654321~ HL*32191~ TRN1100012345987654321~ UMHS100012345987654321~ HCRA1ZZZ001~ HIBF:7295:::3~ HIBF:72148:::1~ HIBF:72156:::1~ HIBF:72158:::1~ HIBF:S72.0:::1~ HIBF:M16.10:::1~ SE130001~ GE11~ IEA1*000000001~

ADT A08 Event

ADT:

MSH|^~&|EMRSENDER|FACILITY_A|RECEIVER|FACILITY_A|20230504||ADT^A08^ADT_A01|0001|P|2.5 EVN|A08|20230504|||BROWN^SARAH|20230504 PID|||100012345^^^FACILITY_A^MRN||PATIENT^JOHN^M||||||||||||100012345 PV1||I|FLOOR^1001^1^FACILITY_A||||987654321^DOE^JANE|||||||||||||||||||||||||20230504 PV2|||^^^FACILITY_A|||||||||||||||||||||||||||||||||||||3 PV3|3|ICD10|S72.0^M16.10^Z96.649 PV4||O AL1|1|||^^^72148^72156^72158 DG1|1|ICD10|S72.0|Fracture of neck of femur|20230504 DG1|2|ICD10|M16.10|Bilateral primary osteoarthritis of hip|20230504 ZCD|3|CPT|72148^72156^72158

Clinical Document

CCD:

Clinical Document

Patient: John Patient

Date: 2023-05-04

Chief Complaint: John experienced a fall, resulting in a hip injury. The patient complains of severe pain and difficulty in walking.

History of Present Illness: The patient has a history of bilateral primary osteoarthritis of the hip (M16.10). The fall exacerbated the existing condition, causing fracture of the neck of femur (S72.0).

Physical Examination: Upon examination, the patient had severe pain, limited range of motion, and swelling of the affected hip. Imaging studies were ordered to assess the extent of the damage.

Imaging Studies:

1. MRI of the pelvis (CPT 72148)
2. MRI of the bilateral hips (CPT 72156)
3. MRI of the bilateral femurs (CPT 72158)

The MRI scans revealed significant damage to the hip joint, confirming the fracture of the neck of femur (S72.0) and worsening of the bilateral primary osteoarthritis of the hip (M16.10).

Assessment: Based on the clinical findings and imaging results, it is evident that the patient requires immediate surgical intervention to repair the hip joint and prevent further complications.

Plan:

1. Admit the patient to the hospital for surgical treatment.
2. Perform an emergent hip replacement surgery (Z96.649) to repair the hip joint and restore function.
3. Postoperative rehabilitation and physical therapy to regain strength and mobility.

Medical Necessity: The emergent hip replacement surgery is medically necessary due to the following factors:

• Severe pain and functional impairment caused by the fracture of the neck of femur (S72.0)
• Worsening of pre-existing bilateral primary osteoarthritis of the hip (M16.10)
• High risk of complications if left untreated

Based on the clinical evidence, the patient's condition warrants immediate surgical intervention to alleviate pain, restore function, and prevent further complications. The surgery is deemed medically necessary to improve the patient's quality of life and long-term prognosis.

Attending Physician: Dr. Sarah Brown

Note and Summary Index by Code Type

Code Value	Code Description	Code Type	Decision Relevance	Additional Information
7295	Authorization and Referral Services	EDI	Required for authorization
72148	MRI of the pelvis	CPT	Medical necessity for imaging
72156	MRI of the bilateral hips	CPT	Medical necessity for imaging
72158	MRI of the bilateral femurs	CPT	Medical necessity for imaging
S72.0	Fracture of the neck of femur	ICD10	Diagnosis, treatment decision
M16.10	Bilateral primary osteoarthritis of the hip	ICD10	Diagnosis, treatment decision
Z96.649	Presence of unspecified artificial hip joint	ICD10	Procedure, treatment decision
A08	Update Patient Information	ADT Event	Patient update after surgery
72148	MRI of the pelvis	ZCD	Diagnostic code for imaging
72156	MRI of the bilateral hips	ZCD	Diagnostic code for imaging
72158	MRI of the bilateral femurs	ZCD	Diagnostic code for imaging
987654321	Dr. Jane Doe - Initial Attending Physician	NPI	Patient care provider	Taxonomy: 207Q00000X (Family Medicine)
123456789	Dr. Robert Smith - Second Attending Physician	NPI	Patient care provider	Taxonomy: 207Q00000X (Family Medicine)
000000001	Dr. Sarah Brown - Surgeon	NPI	Patient care provider, surgery	Taxonomy: 207XS0106X (Orthopedic Surgery)
555444333	Facility A	Facility NPI	Patient care facility	Name: Facility A
		Facility Address		Address: 123 Main St, City, State, Zip Code
J7325	Hyaluronan or derivative, Synvisc or Synvisc-One, for intra-articular injection, 1 mg	HCPCS	Medication used during treatment
Q4081	Injection, dexamethasone sodium phosphate, 1 mg	HCPCS	Medication used during treatment
99238	Hospital discharge day management, 30 minutes or less	CPT	Follow-up plan
99239	Hospital discharge day management, more than 30 minutes	CPT	Follow-up plan