Unique Plan Description: Neuro CVA Clinic
Plan Selection Display: Neuro CVA Clinic
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-02-28 18:37:51
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2022-08-03 16:20:42
Available at all facilities: No

Neuro CVA Clinic
Laboratory
	Sed Rate
		T;N, Routine, spec type = Blood
	ANA Screen
		T;N, Routine, spec type = Blood
	Free T4
		T;N, Routine, spec type = Blood
	TSH
		T;N, Routine, spec type = Blood
	Lipid Panel
		T;N, Routine, spec type = Blood
	Hemoglobin A1C
		T;N, Routine, spec type = Blood
Less than 50 yrs old
	Anti-Thrombin III Enzymatic (Activity)
		T;N, Routine, spec type = Blood
	Prothrombin (F2) G20210A Pathogenic Variant (PreAuth Req)
		T;N, Routine, spec type = Blood
	Factor V Leiden Mutation  (PreAuth Req)
		T;N, Routine, spec type = Blood
	Protein C Functional
		T;N, Routine, spec type = Blood
	Protein S Functional
		T;N, Routine, spec type = Blood
	Homocysteine Total
		T;N, Routine, spec type = Blood
	Cardiolipin Antibodies IgG and IgM
		T;N, Routine, spec type = Blood
	Rheumatoid Factor Quantitative
		T;N, Routine, spec type = Blood
	Basic Metabolic Panel
		T;N, Routine, spec type = Blood
	CBC with Diff
		T;N, Routine, spec type = Blood
	INR - MH/WH/JE
		T;N, Routine, spec type = Blood
	PTT - MH/WH/JE
		T;N, Routine, spec type = Blood
Diagnostic Tests
MRI
	MRI Brain w/o Contrast
		T;N, Routine
	MRI Brain w & w/o Contrast
		T;N, Routine
Ultrasound
	Carotid Artery Duplex Bil
		T;N
Diagnostics
	Echo w Doppler resting
		T;N
			Comment: TEE
		T;N
			Comment: TTE
	ECG
		T;N
	CTA Neck
		T;N, Routine
	MRA Neck w & w/o Contrast
		T;N, Routine
	CT Neck w & w/o Contrast
		T;N, Routine
	MRA Head w & w/o Contrast
		T;N, Routine
	CTA Head
		T;N, Routine
Patient Care

	ECG w/ interpretation and report
		
Consults/Follow-up
	Follow-up Appointment
		Follow Up Visit, PRN
		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
	Consult Physical Therapy
		
	Consult Occupational Therapy
		
	Consult Speech Therapy
		
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
	99024 EVM - Post Op Visit
		T;N
	99211n EVM - No Charge Professional Service
		T;N
	99213C EVM - MPC CLINIC AUDIT BY CODER
		T;N

Neuro Hypercoagulation Studies
Laboratory

	CBC with Diff
		T;N, Routine, spec type = Blood
	INR - MH/WH/JE
		T;N, Routine, spec type = Blood
	PTT - MH/WH/JE
		T;N, Routine, spec type = Blood
	Sed Rate
		T;N, Routine, spec type = Blood
	ANA Reflexive Panel
		T;N, Routine, spec type = Blood
	Basic Metabolic Panel
		T;N, Routine, spec type = Blood
	Anti-Thrombin III Enzymatic (Activity)
		T;N, Routine, spec type = Blood
	Protein C Functional
		T;N, Routine, spec type = Blood
	Protein S Functional
		T;N, Routine, spec type = Blood
	Rheumatoid Factor Quantitative
		T;N, Routine, spec type = Blood
	Cardiolipin Antibodies IgG and IgM
		T;N, Routine, spec type = Blood
	Prothrombin (F2) G20210A Pathogenic Variant (PreAuth Req)
		T;N, Routine, spec type = Blood
	Factor V Leiden Mutation  (PreAuth Req)
		T;N, Routine, spec type = Blood
	MTHFR PCR  (PreAuth Req)
		T;N, Routine, spec type = Blood

*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