Unique Plan Description: IM Chest Pain SOB Work Up Clinic
Plan Selection Display: IM Chest Pain SOB Work Up Clinic
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2011-11-11 09:26:41
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-06-19 10:30:23
Available at all facilities: Yes

IM Chest Pain SOB Work Up Clinic
Laboratory
	CBC with Diff
		T;N, Routine, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Routine, spec type = Blood
	TSH
		T;N, Routine, spec type = Blood
	D-Dimer - MH/WH/JE
		T;N, Routine, spec type = Blood
	D-Dimer Level - FH
		T;N, Routine, spec type = Blood
	ProBNP
		T;N, Routine, spec type = Blood
	B-Type Natriuretic Peptide - FH
		T;N, Routine, spec type = Blood
	hs Troponin T - MH/WH/JE
		T;N, Routine, spec type = Blood
	hs Troponin I - FH
		T;N, Routine, spec type = Blood
	Myoglobin
		T;N, Routine, spec type = Blood
Diagnostic Tests
	Nuclear Stress Treadmill
		T;N
	Nuclear Stress Lexiscan
		T;N
	Nuclear Stress Dobutamine
		T;N
	Echo w Doppler resting
		T;N
	Echo Stress Dobutamine
		T;N
	Echo Stress
		T;N
	Chest 2 View
		T;N
	CTA Chest Pulmonary Arteries
		T;N
Patient Care
	94760 Pulse Oximetry- Single
		
	94010 Spirometry Clinic
		
	ECG w/ interpretation and report
		
Consults/Follow-up
	Return to Clinic Primary Care
		Future Order In Approximately 1 week(s) Grace Period (+/-) 2 Day(s), 2, Day(s), 1, week(s), In Approximately
		Future Order In Approximately 2 week(s) Grace Period (+/-) 2 Day(s), 2, Day(s), 2, week(s), In Approximately
		Future Order In Approximately 3 week(s) Grace Period (+/-) 3 Day(s), 3, Day(s), 3, week(s), In Approximately
		Future Order In Approximately 6 week(s) Grace Period (+/-) 7 Day(s), 7, Day(s), 6, week(s), In Approximately
		Future Order In Approximately 1 month(s) Grace Period (+/-) 7 Day(s), 7, Day(s), 1, month(s), In Approximately
		Future Order In Approximately 2 month(s) Grace Period (+/-) 7 Day(s), 7, Day(s), 2, month(s), In Approximately
		Future Order In Approximately 3 month(s) Grace Period (+/-) 7 Day(s), 7, Day(s), 3, month(s), In Approximately
		Future Order In Approximately 4 month(s) Grace Period (+/-) 7 Day(s), 7, Day(s), 4, month(s), In Approximately
		Future Order In Approximately 6 month(s) Grace Period (+/-) 7 Day(s), 7, Day(s), 6, month(s), In Approximately
		Future Order In Approximately 12 month(s) Grace Period (+/-) 14 Day(s), 14, Day(s), 12, month(s), In Approximately
	Follow-up Appointment
		Follow Up Visit, 3 months
		Follow Up Visit, 1 week
		Follow Up Visit, 2 weeks
		Follow Up Visit, 3 weeks
		Follow Up Visit, 1 month
		Follow Up Visit, 6 months
		Follow Up Visit, 1 year
		Follow Up Visit, See Special Instructions
		Follow Up Visit, PRN
	Complete pre and post PFT's
		T;N
	Consult Cardiologist
		
	Consult Pulmonologist
		
Charges/Supplies
Est. Pt Visit
	99211 EVM - OP visit estab patient, minimal care < 10 min
		T;N
	99212 EVM - OP VISIT ESTAB PATIENT, STRAIGHTFORWARD 10 MIN
		T;N
	99213 EVM - OP VISIT ESTAB PATIENT, LOW LEVEL 20 MIN
		T;N
	99214 EVM - OP VISIT ESTAB PATIENT, MODERATE 30 MIN
		T;N
	99215 EVM - OP VISIT ESTAB PATIENT, HIGH LEVEL 40 MIN
		T;N
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
	99024 EVM - Post Op Visit
		T;N
	99211n EVM - No Charge Professional Service
		T;N
	99213C EVM - MPC CLINIC AUDIT BY CODER
		T;N

*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