Unique Plan Description: OBGYN Pelvic Mass Clinic
Plan Selection Display: OBGYN Pelvic Mass Clinic
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-03-29 14:39:56
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-01-26 08:13:42
Available at all facilities: Yes

OBGYN Pelvic Mass Clinic
Laboratory
	CA 125
		T;N, Routine, spec type = Blood
	CEA
		T;N, Routine, spec type = Blood
	Inhibin A
		T;N, Routine, spec type = Blood
	Inhibin B
		T;N, Routine, spec type = Blood
	LD
		T;N, Routine, spec type = Blood
	AFP
		T;N, Routine, spec type = Blood
	Estradiol Level
		T;N, Routine, spec type = Blood
	Anti Mullerian Hormone
		T;N, Routine, spec type = Blood
	HCG Qualitative Serum - PC/FH
		T;N, Routine, spec type = Blood
	Beta-HCG Quantitative - Pregnancy
		T;N, Routine, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Routine, spec type = Blood
	Testosterone Total (Female or Child)
		T;N, Routine, spec type = Blood
	Hemogram (CBC no Diff)
		T;N, Routine, spec type = Blood
Urine Studies
	Pregnancy Test Urine
		T;N, Routine, Routine, spec type = Urine
Diagnostic Tests

	US Pelvis Complete Non OB
		T;N, Routine
	US Transvaginal
		T;N, Routine
	US Pelvis Limited
		T;N, Routine
	US Abd Complete
		T;N, Routine
	US Abd Limited
		T;N, Routine
	CT Abd Pelvis w & w/o Cont
		T;N, Routine
	CT Abd Pelvis w Contrast
		T;N, Routine
	CT Abd Pelvis w/o Contrast
		T;N, Routine
	IVP
		T;N, Routine
	Chest 1 View
		T;N, Routine
Consults/Follow-up
	Consult Gyn Oncologist
		
	Consult Other
		
	Follow-up Appointment
		Follow Up Visit, PRN
		Follow Up Visit, 1 week
		Follow Up Visit, 2 weeks
		Follow Up Visit, 3 weeks
		Follow Up Visit, 1 month
		Follow Up Visit, 3 months
		Follow Up Visit, 6 months
		Follow Up Visit, 1 year
		Follow Up Visit, See Special Instructions
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
	99213C EVM - MPC CLINIC AUDIT BY CODER
		T;N
	99211n EVM - No Charge Professional Service
		T;N
Procedures in Office
	76857 Limited/Follicular non OB (in office)
		
	76830 US Transvaginal non OB (in office)

*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