Ann is a 60-year-old woman with significant hypertensive heart disease who was admitted to the hospital for an arthroplasty on her right wrist. Given her heart disease, the patient underwent cardiac clearance prior to admission, and was cleared for surgery. The patient also has a history of breast cancer. She had a double mastectomy nine years ago and after treatment, has had no recurrence of the

disease.

The patient was seen in my office two weeks ago, complaining of pain in the right wrist. She denied any injury to the wrist. After running a series of tests, x-rays, and bone scintigraphy, she was diagnosed with idiopathic avascular necrosis of the carpal bone.

First-listed diagnosis/principal diagnosis: ________
Secondary diagnoses: ________
Fill in the blank with correct word.

First-listed diagnosis/principal diagnosis: ________
Answer: Idiopathic avascular/aseptic necrosis, right carpal bone – M87.037

Secondary diagnoses: ________
Answer: Hypertensive heart disease – I11.9; personal history of breast cancer – Z85.3; absence (acquired) both breasts – Z90.13