Unique Plan Description: Peds Asthma Clinic
Plan Selection Display: Peds Asthma Clinic
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-02-14 07:49:17
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-06 10:38:27
Available at all facilities: Yes

Peds Asthma Clinic
Laboratory
	Hemogram (CBC no Diff)
		T;N, Routine, spec type = Blood
	CBC with Diff
		T;N, Routine, spec type = Blood
Diagnostic Tests
	Chest 2 View
		T;N, Routine
			Comment: pre-nebulizer treatment, return to physician office after x-ray
		T;N, Routine
			Comment: post-nebulizer treatment
Medications
	cefTRIAXone 250mg IM (Rocephin) (In Office)
		0 mg, Injection, IM-Intramuscular, Once, NOW
			Comment: Inject deep into Muscle. Dosage depending upon weight
		2,000 mg, Injection, IVPB, Once, NOW
		1,000 mg, Injection, IVPB, Once, NOW
		2,000 mg, Injection, IM-Intramuscular, Once, NOW
			Comment: Inject deep into Muscle
		1,000 mg, Injection, IM-Intramuscular, Once, NOW
			Comment: Inject deep into Muscle
	dexamethasone (Decadron) 4mg/mL  (In Office)
		0 mg, Tab, BY MOUTH, Once, NOW
		4 mg, Tab, BY MOUTH, Once, NOW
		6 mg, Tab, BY MOUTH, Once, NOW
	racepinephrine (racemic EPINEPHrine 2.25% inhalation solution) (In Office)
		0.5 mL, Solution-Nebulization, NEBULIZED, Once, NOW
			Comment: Dilute with 3mL sodium chloride 0.9% inhalation solution.
	sodium chloride 0.9% inhalation solution (In Office)
		3 mL, Solution-Nebulization, NEBULIZED, Once, NOW
			Comment: Use to dilute 0.5mL racemic EPINEPHrine 2.25%.
	albuterol 2.5 mg/3 mL (0.083%) inh soln (In Office)
		3 mL, Solution, Nebulization, NEBULIZED, Once, NOW
	ipratropium (Atrovent) (In Office)
		2.5 mL, Solution-Nebulization, NEBULIZED, Once, NOW
	albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution
		3 mL INHALATION QID, PRN for wheezing, # 30 EA, 3 Refill(s)
		3 mL INHALATION QID, PRN for wheezing, # 60 EA, 3 Refill(s)
	albuterol 2.5 mg/3 mL (0.083%) inh soln
		3 mL INHALATION Q4-6H, PRN for wheezing, # 50 EA, 1 Refill(s)
Patient Care
	94640 Inhalation treatment
		
	94760 Pulse Oximetry- Single
		
	94010 Spirometry Clinic
		
Consults/Follow-up
	Follow-up Appointment
		Follow Up Visit, See Special Instructions
		Follow Up Visit, 1 week
		Follow Up Visit, 2 weeks
		Follow Up Visit, 3 weeks
		Follow Up Visit, 6 weeks
		Follow Up Visit, 1 month
		Follow Up Visit, 3 months
		Follow Up Visit, 6 months
		Follow Up Visit, 1 year
		Follow Up Visit, PRN
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
	99024 EVM - Post Op Visit
		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