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ICD-9-CM CODES

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  • 153.9 Malignant neoplasm of colon, unspecified site

  • Associated physical therapy diagnoses

    • 315.4 Coordination disorder (clumsiness, dyspraxia and/or specific motor development disorder)

    • 718.45 Contracture of joint, pelvic region and thigh

    • 719.70 Difficulty in walking

    • 728.2 Muscular wasting and disuse atrophy

    • 728.89 Disorders of muscle, ligament and fascia

    • 729.9 Other disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 781.2 Abnormality of gait: Ataxic, paralytic, spastic, staggering

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

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ICD-10-CM CODE

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  • C18.9 Malignant neoplasm of colon, unspecified

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PREFERRED PRACTICE PATTERN

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As of July, 2014, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology. Therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.

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FIGURE 63-1

Algorithm for treatment of colorectal hemorrhage. NG = nasogastric; 99mTc = technetium-99; RBC = red blood cell. (Reproduced with permission from Gordon PH, Nivatvongs S, eds. Principles and Practice of Surgery for the Colon, Rectum, and Anus. 2nd ed. New York, NY: Marcel Dekker, Inc.; 1999: p. 1279.)

Graphic Jump Location
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FIGURE 63-2

Diagnostic and therapeutic algorithm for colon cancer. (From Kantarjian HM, Wolff RA, Koller CA. The MD Anderson Manual of Medical Oncology. 2nd ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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PATIENT PRESENTATION

A 34-year-old female presents to PT with complaints of general weakness, 2 weeks after being discharged from a 40-day admission to the hospital. She was previously employed as a CAN nurse, but has not worked in the past year since her diagnosis. She went into respiratory failure after her surgery (colon tumor resection, hemidiaphragm hernia repair, and hysterectomy with bilateral salpingo-oophorectomy). She was intubated and still has her feeding tube in, although, she is not using it currently. She expects to get it removed in the next few weeks. She lives in a two-level home with her family. She has difficulty getting up the stairs and has to use both arms to pull herself up them. She is independent with ADLs; however, uses supervision assist during showering for safety. She also uses hand held assist when getting into the shower as it is a step-over tub/shower. She is experiencing daily vomiting, usually in the mornings and constipation from the pain medicines. She has a lot of pain and numbness in her whole body with sleeping at night; however, she feels that the right side of her body is worse than the left. It also feels weaker than the left side. In addition, she has low back pain that started during her hospital admission.

Structural assessment includes: flat lumbar spine with patient maintaining a forward bent torso during standing, walking, and sitting. She is ...

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