Unique Plan Description: ID Fever Work Up Clinic
Plan Selection Display: ID Fever Work Up Clinic
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-03-06 17:44:12
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2022-01-27 13:25:20
Available at all facilities: Yes

ID Fever Work Up Clinic
Laboratory
	CBC with Diff
		T;N, Routine, spec type = Blood
	Comprehensive Metabolic Panel
		T;N, Routine, spec type = Blood
	hsCRP
		T;N, Routine, spec type = Blood
	UA (Culture if Positive)
		T;N, Routine, Routine, spec type = Urine
	LD
		T;N, Routine, spec type = Blood
	HIV-1/2 Ag/Ab Combo - MH/WH/JE
		T;N, Routine, spec type = Blood
	Acute Hepatitis Panel with Rflx to Hepatitis C Confirm
		T;N, Routine
	Rheumatoid Factor Quantitative
		T;N, Routine, spec type = Blood
	Infectious Mononucleosis Screen
		T;N, Routine, spec type = Blood
	ANA Screen
		T;N, Routine, spec type = Blood
	zzCytomegalovirus (CMV) by Quantitative PCR
		T;N, Routine, spec type = Blood
	Epstein Barr Virus DNA PCR Quant
		T;N, Routine, spec type = Blood
	zzANCA
		T;N, Routine, spec type = Blood
	Epstein Barr Virus Antibody Panel
		T;N, Routine, spec type = Blood
Diagnostic Tests
	Echo w Doppler resting
		T;N
			Comment: Dr Salfity to read
	Chest 2 View
		T;N, Routine
	CT Abd Pelvis w Contrast
		T;N, Routine
	CT Chest w Contrast
		T;N, Routine
Medications
	tuberculin purified protein derivative (PPD) (In Office)
		0.1 mL, Injection, IntraDermal, Once, NOW
Consults/Follow-up
	Follow-up Appointment
		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
		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

Blood Culture Set
Laboratory

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	.Blood Culture.
		T;N, Stat, spec type = Blood
		T;N, Routine, spec type = Blood
		Timed, spec type = Blood
		T+1;0400, Routine, spec type = Blood
	.Blood Culture
		T;N, Stat, spec type = Blood
		T;N, Routine, spec type = Blood
		Timed, spec type = Blood
		T+1;0400, Routine, spec type = Blood

*Report Legend:
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IND - This component is an indicator
INT - This component is an intervention
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NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase