Unique Plan Description: GYNONC New Patient Dysplasia Clinic
Plan Selection Display: GYNONC New Patient Dysplasia Clinic
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2011-11-29 14:29:41
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-06 09:12:01
Available at all facilities: Yes

GYNONC New Patient Dysplasia Clinic
Laboratory
	CBC with Diff
		T;N, Routine, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Routine, spec type = Blood
	GYN Pap with Reflex to HPV High Risk
		T;N, Routine TL PAP CERVICAL, Routine
		T;N, Routine TL PAP CV & VAG, Routine
		T;N, Routine TL PAP VAGINAL, Routine
Diagnostic Tests
	Chest 2 View
		T;N, Routine
	ECG w/ interpretation and report
		Routine
Patient Care
	Patient Instructions
		Effudex
Consults/Follow-up
	Consult OB/GYN
		
	Consult Colorectal Surgery
		
Charges/Supplies
New Pt Visit
	zz99201 EVM-New Pt Visit Problem focused 10m
		T;N
	99202 EVM - OP VISIT NEW PATIENT, STRAIGHTFORWARD 15 MIN
		T;N
	99203 EVM - OP VISIT NEW PATIENT, LOW LEVEL 30 MIN
		T;N
	99204 EVM - OP VISIT NEW PATIENT, MODERATE LEVEL 45 MIN
		T;N
	99205 EVM - OP VISIT NEW PATIENT, HIGH LEVEL 60 MIN
		T;N
No Charge / Follow Up
	99211n EVM - No Charge Professional Service
		T;N
	99213C EVM - MPC CLINIC AUDIT BY CODER
		T;N
Procedures in Office
		Vagina/Vulva(NOTE)*
	57100 Biopsy vaginal mucosa simple
		
	56605 Biopsy vulva or perineum, 1 lesion
		
	56606 Biopsy vulva or perineum, ea addl
		
	57420 Colposcopy, Vagina
		
		Cervix(NOTE)*
	57500 Cervical Biopsy/Polypectomy
		
	57421 Colposcopy  Vagina and Cervix, Biopsy
		
	57452 Colposcopy  Cervix and Upper Vagina
		
	57505 Endocervical Curettage
		
		Uterus(NOTE)*
	58110 Endometrial Biopsy during Colposcopy
		
	58100 Endometrial bx wo cervical dilation
		
	56821 Colposcopy  Vulva , Biopsy

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase