Hip Pain Relief Piriformis SI joint Yoga Tune Up
lastly you need to use your Yoga Tune Up Balls to target powerful muscle call the piriformis. the the piriformis is a major muscle in yourbuttocks. that helps to rotate your thigh bone outwards. The muscle starts right about at your SI joint that's called the sacroiliac joint.
You can find it by looking for the dimples in your sacrum There's a little dimple here on the inner edgeof each buttock. so you take your balls and place it right thereon that dimple and then slowly start to shimmy you hips along the muscle from side to side.
the muscle the piriformis overlies the sciatic nerve and often when people have sciatic nerve painit's because the piriformis is so tight now because you're shimmying and your buttocksdo have some amount of size to them from time to time you're gonna have to resetthe balls because your buttocks are going to be pushing the balls out of the way and one more thing to do to get deeper intothat piriformis is to drop one knee the at a time as you shimmy
and he will definitely need to reset yourballs but oh my goodness this is so incredible What a massage, right into that piriformis.
Medical Coding Difficult Operative Reports
We had a question come in about coding difficultOp reports. Actually, they didn't give us an Op report to use as an example, but thisis what the person have asked about this, was struggling with. What I did was I pulledout, I found an Op report, it was too big, was taking forever we didn't want to readit. So, I just took out the Postop diagnosis in the procedure performed and thought wewould just go with that. Q. For your Postop diagnosis, we had statuspost coronary artery bypass grafting and aortic valve replacement. We got a postoperativecourse complicated with respiratory insufficiency and chronic renal insufficiency requiringhemodialysis. The patient developed sternal
dehiscence and required rewiring that'severything that happened, it was pertinent to postop. So, what did they doé They did sternal rewiringusing Robicsek technique, insertion of irrigation system catheters with mediastinal and rightpleural chest tube, bilateral myocutaneous pectoralis muscle flap advancements, and insertionof a new right subclavian vein Quinton catheter for hemodialysis. Now, notice that they saidquot;new right subclavian veinquot; that means the person was on hemodialysis before. Now, key terms, for ICD9, these are the thingsthat you want to pull out of that. This person
is post CABG, post valve replacement, complicationrespiratory insufficiency, chronic renal insufficiency, dialysis status. Now, when you have dialysisstatus, when you first read this, you may think, quot;Oh, he required dialysis, was he startedon dialysiséquot; Now we know because it says quot;new right subclavianquot; catheter was put in.He was on dialysis before. And sternal dehiscence. Let's look at the CPT, the part that she washaving problem with was which codes should she useé It was going to be 15732 muscle,myocutaneous, or fasciocutaneous flap, head and neck. Then, it gives you what musclesare involved sternocleidomastoid, levator scapulae. And the plain English description:quot;The physician utilizes a graft of muscle,
muscle and skin, or muscle fascia and a skinflap to repair a defect.quot; That's actually what they're doing. quot;The flap is preparedfrom the donor site,quot; so whenever you're doing this type of thing, you're going to have toalso work on, there will be things that you'll work up from the removal of the donor tissueand the repair of the site that the donor tissue was removed from. quot;The flap is prepared from the donor siteand then rotated to cover the defectquot; so, the donor site is just right there by it andthey kind of twist it and lay it over the defect. quot;The flap is sutured into place andthe donor site is closed with sutures or a
skin graft.quot; So, you got to repair the sitethat the graft is being taken from. quot;If a skin graft is needed to close the donor site,report this procedure separately. Code 15732 for donor sites on the head andor neck; 15734for donor sites on the trunk; 15736 for donor sites on the upper extremities; and 15738for donor sites on the lower extremities.quot; OK, that's where she was having the troublewith, the complications, what do we do with that, what codes to useé But, you also needto pay attention to the tube insertions that were done and the hemodialysis catheter whenyou go to code this. But that's how you pull up information, kind of a brief synopsis ofpulling out from the postoperative diagnosis
and the procedure performed. When you're doingOp reports, you want to look at the preop diagnosis and the postop diagnosis. Oftenthey're not going to change, but they can change so you'll be coding off the postopdiagnosis.