Emergency department visit episode 1: Patient had been drinking heavily in recent weeks. While visiting the area he reduced his alcohol intake during the past 24 hours and suffered a seizure. In the emergency department, he seemed to be normal. No neurological or physical abnormalities were noted, and he was released after receiving Dilantin. Diagnosis: Seizure, probably due to alcohol withdrawal. Inpatient admission episode 2: The patient returned to his room at a local motel, had another seizure, and then fell in the bathroom. He was again brought to the emergency department and found to have a dislocated shoulder. Several attempts were made to replace the shoulder to its proper position. Because this reduction was not successful, he was admitted. With medications to control alcohol withdrawal and seizures along with |V fluids, he became mentally clear. A closed reduction of the dislocated shoulder was performed. The injury became a difficult management problem because the patient would not leave the orthopedic appliance on, and the next day a heavy plaster cast was placed on the shoulder to ensure correct positioning and active reduction. Discharge diagnosis: alcohol withdrawal seizure, left shoulder dislocation What diagnosis would you code as your principal diagnosis on Episode 2? O S43.005D @ S43.005A O F10.239 O R56.9
