Unique Plan Description: Peds Musculoskeletal Injury Clinic
Plan Selection Display: Peds Musculoskeletal Injury Clinic
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-02-14 21:06:24
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-11-07 14:10:14
Available at all facilities: Yes

Peds Musculoskeletal Injury Clinic
Laboratory
	Hemogram (CBC no Diff)
		T;N, Routine, spec type = Blood
	CBC with Diff
		T;N, Routine, spec type = Blood
	Sed Rate
		T;N, Routine, spec type = Blood
	hsCRP
		T;N, Routine, spec type = Blood
	Culture Wound
		T;N, Routine
	ANA Screen
		T;N, Routine, spec type = Blood
	Rheumatoid Factor Quantitative
		T;N, Routine, spec type = Blood
Diagnostic Tests
	Abd
		T;N, Routine
	Ankle 3 View Lt
		T;N, Routine
	Ankle 3 View Rt
		T;N, Routine
	Chest 2 View
		T;N, Routine
	Elbow Min 3 View Rt
		T;N, Routine
	Elbow Min 3 View Lt
		T;N, Routine
	Femur Lt
		T;N, Routine
	Femur Rt
		T;N, Routine
	Finger 2nd Lt
		T;N, Routine
	Finger 3rd Lt
		T;N, Routine
	Finger 4th Lt
		T;N, Routine
	Finger 5th Lt
		T;N, Routine
	Finger Thumb Lt
		T;N, Routine
	Finger 2nd Rt
		T;N, Routine
	Finger 3rd Rt
		T;N, Routine
	Finger 4th Rt
		T;N, Routine
	Finger 5th Rt
		T;N, Routine
	Finger Thumb Rt
		T;N, Routine
	Foot 3 View Lt
		T;N, Routine
	Foot 3 View Rt
		T;N, Routine
	Forearm Lt
		T;N, Routine
	Forearm Rt
		T;N, Routine
	Forearm Bil
		T;N, Routine
	Hand 3 View Lt
		T;N, Routine
	Hand 3 View Rt
		T;N, Routine
	Hands 3 View Bil
		T;N, Routine
	Hip Min 2 View Lt
		T;N, Routine
			Comment: AP lateral and frog legs
	Hip Min 2 View Rt
		T;N, Routine
			Comment: AP lateral and frog legs
	Humerus Lt
		T;N, Routine
	Humerus Rt
		T;N, Routine
	Knee 3 View Lt
		T;N, Routine
	Knee 3 View Rt
		T;N, Routine
	Pelvis Min 3 View
		T;N, Routine
	Ribs 2 View Lt
		T;N, Routine
	Ribs 2 View Rt
		T;N, Routine
	Shoulder Min 2 View Lt
		T;N, Routine
	Shoulder Min 2 View Rt
		T;N, Routine
	Spine Thoracic AP & Lat
		T;N, Routine
	Spine Lumbar AP & Lat
		T;N, Routine
	Spine Lumbar w Obl
		T;N, Routine
	Tibia & Fibula Lt
		T;N, Routine
	Tibia & Fibula Rt
		T;N, Routine
	Tibia & Fibula Bil
		T;N, Routine
	Toe 2nd Lt
		T;N, Routine
	Toe 3rd Lt
		T;N, Routine
	Toe 4th Lt
		T;N, Routine
	Toe 5th Lt
		T;N, Routine
	Toe Great Lt
		T;N, Routine
	Toe 2nd Rt
		T;N, Routine
	Toe 3rd Rt
		T;N, Routine
	Toe 4th Rt
		T;N, Routine
	Toe 5th Rt
		T;N, Routine
	Toe Great Rt
		T;N, Routine
	Wrist Min 3 View Lt
		T;N, Routine
	Wrist Min 3 View Rt
		T;N, Routine
	Wrist Min 3 View Bil
		T;N, Routine
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
	Consult Physical Therapy
		
	Consult Occupational Therapy
		
	Consult Orthopedics
		
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
	99024 EVM - Post Op Visit
		T;N
	99211n EVM - No Charge Professional Service
		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