1. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. THE COMPLETE DIAGNOSIS CODING SOLUTION THIRD EDITION Chapter 18 Coding Diseases of the Urinary System 18-1

2. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Learning Outcomes 18.1 Identify the components of the urinary system. 18.2 Explain the signs and symptoms of urologic malfunction. 18.3 Explain the stages of chronic kidney disease. 18-2

3. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Learning Outcomes (cont.) 18.4 Determine how to code chronic kidney disease when found with other conditions. 18.5 Report infections in urinary organs correctly. 18.6 Report conditions affecting the prostate accurately. 18-3

4. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Key Terms Anemic Benign prostatic hyperplasia (BPH) Bladder cancer Chronic kidney disease (CKD) Glomerular filtration rate (GFR) 18-4

5. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Key Terms (cont.) Kidney Prostatitis Urea Ureter Urethra 18-5

6. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Key Terms (cont.) Urinary bladder Urinary system Urinary tract infection (UTI) 18-6

7. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Introduction The components of the urinary system are the same in both men and women. 18-7

8. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Introduction (cont.) This organ system is responsible for removing waste products (urea) that are left behind by protein (food), excessive water, disproportionate amounts of electrolytes, and other nitrogenous compounds from the blood and body. 18-8

9. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. The Urinary System The Kidneys Responsible for producing and eliminating urine, thereby maintaining homeostasis The Ureters Tube-like structures that transport urine, processed by the kidney and ready for elimination, to the urinary bladder Learning Outcome: 18.1 18-9

10. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. The Urinary Bladder The urinary bladder is a sac constructed of muscles, located anteroinferior (in front and below) to the peritoneal cavity. Learning Outcome: 18.1 18-10

11. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. The Urinary Bladder (cont.) The primary sectors of the urinary bladder include: –Fundus –Apex –Body –Neck Learning Outcome: 18.1 18-11

12. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. The Urethra The urethra is a tubular structure that carries urine from the urinary bladder to the outside of the body. Learning Outcome: 18.1 18-12

13. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Diseases and illnesses, congenital anomalies, medications, and pathogens can cause havoc within the urinary system. Learning Outcome: 18.2 18-13 Renal and Urologic Malfunctions

14. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Diagnostic Tools –Blood test –Kidney-ureter-bladder (KUB) –Ultrasonography –IVP (intravenous pyelogram) Learning Outcome: 18.2 18-14 Renal and Urologic Malfunctions (cont.)

15. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Chronic Kidney Disease Chronic kidney disease (CKD) can be caused by disease, trauma, or an adverse reaction to medication. The glomerular filtration rate (GFR) is measured by blood tests to check the creatinine level. Learning Outcome: 18.3 18-15

16. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Chronic Kidney Disease Chronic kidney disease (CKD) may be indicated by lab results: Normal GFR: Kidney damage may exist even with a normal GFR—CKD stage 1 GFR between 60–89: CKD stage 2 (mild renal disease) GFR between 30–59: CKD stage 3 (moderate renal disease) Learning Outcome: 18.3 18-16

17. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Chronic Kidney Disease (cont.) Chronic kidney disease (CKD) may be indicated by lab results (cont.): GFR between 15–29: CKD stage 4 (severe renal disease) GFR below 15: CKD stage 5 End-stage renal disease (ESRD): CKD stage 5 Learning Outcome: 18.3 18-17

18. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. CKD with Other Conditions Hypertensive chronic kidney disease Diabetes with renal manifestations Anemia in CKD Dialysis (two types): –Peritoneal dialysis –Hemodialysis Transplantation Learning Outcome: 18.4 18-18

19. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Acute Renal Failure Acute renal failure (ARF) is a sudden malfunction of the kidney often caused by an obstruction, circulatory problem, or possible renal parenchymal disease. Learning Outcome: 18.4 18-19

20. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Urinary Tract Infection Cystitis and urethritis are both lower urinary tract infections (UTIs), which are often resolved easily with treatment. Learning Outcome: 18.5 18-20

21. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Urinary Tract Infection (cont.) Most UTIs are caused by a Gram- negative enteric bacterium. A use additional code notation directs you to identify the infectious agent. Learning Outcome: 18.5 18-21

22. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Renal Calculi Renal calculi, commonly known as kidney stones, might actually form anywhere within the urinary system; however, formation in the renal pelvis or the calyces of the kidneys is most common. Learning Outcome: 18.5 18-22

23. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Conditions Affecting the Prostate Prostatitis In men, the prostate is a gland that sits inferior to the urinary bladder. The most common underlying condition promoting UTI is prostatitis. Learning Outcome: 18.6 18-23

24. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Benign Prostatic Hyperplasia Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, most often diagnosed in men over 50 years of age, is a condition in which the prostate enlarges and results in depressing the urethra. Learning Outcome: 18.6 18-24

25. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Malignant Neoplasm of the Bladder Malignant neoplasm of the bladder, commonly known as bladder cancer, is the fourth most frequently diagnosed cancer in men and the eighth most frequent in women. Learning Outcome: 18.6 18-25

26. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Chapter Summary The urinary system is designed to remove urea from the blood, manufacture urine, and perform waste removal by eliminating urine. 18-26