Unique Plan Description: URO General Clinic
Plan Selection Display: URO General Clinic
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-03-04 20:35:15
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-03-14 08:51:45
Available at all facilities: Yes

URO General Clinic
Laboratory
	Urogram
		T;N, Routine, Routine, spec type = Urine
	UA
		T;N, Routine, Routine, spec type = Urine
	UA (Culture Pos)
		T;N, Routine, Routine, spec type = Urine
	PSA (For Screening Only)
		T;N, Routine, spec type = Blood
	PSA Diagnostic
		T;N, Routine, spec type = Blood
	Creatinine
		T;N, Routine, spec type = Blood
	CBC with Diff
		T;N, Routine, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Routine, spec type = Blood
	Basic Metabolic Panel
		T;N, Routine, spec type = Blood
	AFP
		T;N, Routine, spec type = Blood
	Beta-HCG Quantitative - Pregnancy
		T;N, Routine, spec type = Blood
	LD
		T;N, Routine, spec type = Blood
	Testosterone Total and Free (Adult Male)
		T;N, Routine, spec type = Blood
	LH
		T;N, Routine, spec type = Blood
	FSH
		T;N, Routine, spec type = Blood
	Prolactin Level
		T;N, Routine, spec type = Blood
	Anti Mullerian Hormone
		T;N, Routine, spec type = Blood
Medications
	testosterone (Depo-Testosterone) (In Office)
		100 mg, Injection, IM-Intramuscular, Once, NOW
		200 mg, Injection, IM-Intramuscular, Once, NOW
Patient Care
	51701 Insert Non-Indwell bladder catheter
		
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, 1 month
		Follow Up Visit, 3 months
		Follow Up Visit, 6 months
		Follow Up Visit, 1 year
		Follow Up Visit, PRN
	Consult Urology
		
Charges/Supplies
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
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
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
Procedures in Office
	51705 Change cystostomy tube
		
	51702 Insert temp indwelling bladder cath simp (foley)
		
	53661 Urethral Dilatation, Subsequent
		
	53660 Urethral Dilation, Initial
		
	54450 Lysis of adhesions; foreskin
		
	zz96372 Injection Ther/Proph/Diag   SC/IM

*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