A finished HIM-350 Topic 7 diagnosis sequencing rationale example, coding one composite inpatient record in full and giving a written reason for every code and its position. Searches like "him 350 topic 7 assignment example", "him350 topic 7 sample" and "him-350 topic 7 example" land here.
What a finished HIM-350 Topic 7 diagnosis sequencing rationale looks like
The finished rationale is a coded list in which every line argues for itself. The composite stay is an older adult admitted with community-acquired pneumonia who also has type 2 diabetes treated with insulin, chronic heart failure on daily medication, a history of stroke with no remaining deficit, and a urinary tract infection that appears on the fourth hospital day. Pneumonia goes first, with its reason tested against the definition. Each secondary code is then tested against the UHDDS criteria for other diagnoses: clinical evaluation, therapeutic treatment, diagnostic procedures, an extended length of stay, or increased nursing care and monitoring. The stroke becomes a history code rather than a current condition. Cough and fever are left uncoded as integral to the pneumonia, and an unremarked potassium value stays off the list. Each code carries its present on admission indicator.
How an HIM-350 Topic 7 example is structured
The rationale is organized as a coded record read from the top down. First comes the composite stay in summary, drawn from the history and physical, progress notes and discharge summary, with key phrases quoted. The principal diagnosis is settled next, in a paragraph that tests it against the definition and names the rejected alternatives. After that the candidates for secondary diagnoses are listed, and each is either admitted to the coded record with the criterion it satisfies, or excluded with its reason: integral to another condition, a finding the provider never interpreted, or a resolved problem with no bearing on the stay. The present on admission indicator is assigned for every reported code, with the day-four infection showing why the field matters. The order of the secondary codes is explained where instructional notes govern it. A closing table sets code, reason and indicator side by side.
Principal chosen, alternatives named
The pneumonia is placed first after a paragraph testing it against the definition, and the chronic conditions considered and rejected for that position are listed beside it.
Five criteria for a secondary code
Each additional condition is admitted only if it required evaluation, treatment, diagnostic work, a longer stay or more nursing care, and the criterion met is named.
Integral symptoms left off the list
Cough and fever are not coded beside the pneumonia, because signs routinely associated with a confirmed condition are not reported separately unless an instruction says otherwise.
History coded as history
The earlier stroke with no remaining deficit is reported as a personal history, since coding it as current would describe a patient who is not in the bed.
An indicator on every code
Present on admission values are assigned throughout, and the infection that began on the fourth day shows the difference the indicator exists to record.
Code, reason and indicator together
A closing table lines up each reported code with its written reason and its indicator, so a reviewer can check the whole record from one page.
Where marks go in HIM-350 Topic 7
Records coded in full still lose marks when the reasons are missing, because a list of correct codes shows the answer and none of the judgment. Adding every condition mentioned anywhere in the chart is the commonest overreach: a chronic problem that received no evaluation, treatment or monitoring during this stay does not meet the criteria for a secondary diagnosis. Integral symptoms coded beside their confirmed cause duplicate information and suggest the relationship went unrecognized. A healed stroke coded as current changes the picture of the patient entirely. Present on admission indicators left blank, or assigned from the admission date instead of from the documentation, undermine the one field that separates conditions brought in from conditions acquired. Drafts that order the secondary codes without explaining the order leave a reviewer guessing whether an instruction or a habit decided it.
Get an HIM-350 Topic 7 example written to your instructions
Send the HIM-350 Topic 7 instructions, the rubric from your classroom and the record or case study your assignment supplies. We write a custom example to those criteria, with the principal diagnosis argued, every secondary code tested against the criteria, excluded conditions explained and present on admission indicators assigned, in 24 to 48 hours. The first one costs nothing.
HIM-350 Topic 7 questions, answered
Which conditions count as secondary diagnoses?
Those that coexist at admission or develop during the stay and affect care in a measurable way. The UHDDS criteria, carried into the official guidelines, look for clinical evaluation, therapeutic treatment, diagnostic procedures, an extended length of stay, or increased nursing care and monitoring. A condition from an earlier episode with no bearing on this stay is left out, and the example accordingly names the criterion met for every secondary code.
Why leave out symptoms the patient clearly had?
Because signs and symptoms routinely associated with a confirmed disease process are not assigned as additional codes unless the classification instructs otherwise. Cough and fever with pneumonia are the ordinary case. A symptom that is not routinely part of the condition may still be coded when it is present, and the example draws that line explicitly for each symptom on the composite chart.
How is present on admission decided?
From the documentation, by asking whether the condition was present at the time the order for inpatient admission occurred. Conditions that developed during an emergency department visit or observation before that order count as present. Where the record leaves the timing unclear, the provider is queried rather than second-guessed. Codes on the published exempt list take no indicator, and the example marks them so a reader does not mistake a blank for an omission.