Unique Plan Description: REN Uro Gyn GI
Plan Selection Display: REN Uro Gyn GI
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-03-28 14:10:09
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-04-24 11:02:58
Available at all facilities: Yes

REN Uro Gyn GI
Laboratory
	Comprehensive Metabolic Panel
		
	Basic Metabolic Panel
		
	LFTs
		
	Acute Hepatitis Panel with Rflx to Hepatitis C Confirm
		
	ALT
		
	AST
		
	Bilirubin Total
		
	Bilirubin Direct
		
	BUN
		
	CEA
		
	CBC with Diff
		
	CMV Antibodies IgG and IgM
		
	Creatinine
		
	Hgb Eval Rflx EP/RBC Solubility
		
	Protein Electrophoresis CSF
		
	Ferritin
		
	Folate
		
	Beta-HCG Quantitative - Pregnancy
		
	Hepatitis B Surface Antigen
		
	Hepatitis C Virus (HCV) Antibody with Rflx to PCR Confirmation
		
	Hepatitis B Surface Antigen
		
	Helicobacter pylori Stool Antigen - MH/WH/JE
		
	Iron
		
	Iron Panel - MH/WH/JE
		
	LH
		
	Microalbumin Urine Random (Spot)
		
	Microalbumin Urine MPC
		
	Phosphorus
		
	PSA
		
	Urinalysis
		
	Vitamin B12 Level
		
	Vitamin D 25-Hydroxy Level (preferred for deficiency)
		
	GC/Chlamydia PCR-MH/WH/PC
		
	GC/Chlamydia(Rapid) DNA - FH/JE
		
	Culture Routine
		
	Acid Fast Culture
		
	Fungal Smear
		
	Stool Pathogen Panel (PCR)
		
		Includes targets for: Campylobacter, Salmonella, Shigella, Vibrio, Yersinia enterocolitica, Shiga Toxins 1 and 2, Norovirus and Rotavirus.(NOTE)*
	Toxigenic Clostridioides Difficile by EIA Reflex to PCR
		
	Giardia/Cryptosporidium Antigen Screen
		
	Hemoglobin
		
Consults/Follow-up
	Consult OB/GYN
		
	Consult General Surgery
		
	Consult Gastroenterologist
		
	Consult Urology
		
	Consult Gyn Oncologist
		
Charges/Supplies
	zz99201 New Patient /Problem Focus
		
	99202 MCH - OP visit new patient, straightforward 15-29 min
		
	99203 MCH - OP visit new patient, low level 30-44 min
		
	99204 MCH - OP visit new patient, moderate level 45-59 min
		
	99205 MCH - OP visit new patient, high level 60-74 min
		
	99211 MCH - OP visit estab patient, minimal care < 10 min
		
	99212 MCH - OP visit estab patient, straightforward 10-19 min
		
	99213 MCH - OP visit estab patient, low level 20-29 min
		
	99214 MCH - OP visit estab patient, moderate 30-39 min
		
	99215 MCH - OP visit estab patient, high level 40-54 min
		
	99384 MCH - Initial Eval-New Patient 12-17
		
	99385 MCH - Initial Eval-New Patient 18-39
		
	99386 MCH - Initial Eval-New Patient 40-64
		
	99395 Annual Exam; 18-39 Years
		
	99396 Annual Exam; 40-64 Years
		
	99397 Annual Exam; 65 Years or >
		
	99401 MCH - Indiv Health Education - 15 min
		
	99402 MCH - Indiv Health Education - 30 min
		
	99403 MCH - Indiv Health Education - 45 min
		
	36415 Venipuncture
		
	82962 MCH - lucose by Monitor
		
	81025 MCH - Pregnancy Test
		
	81002 MCH - UA by Dip Stick
		
	87210 MCH - Wetmount

*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