Download Tuna Cardiology

TUNA TEXAS CARDIOLOGY
Patient Number
877 555-1212
Ticket Number
Service Date
Prior Balance
Pat
Patient Name
Gender
Address
Phone
Ins
Other
SSN
Referring Dr.
Total
Primary Insurance Co.
Policy/Group ID
Paymt
Secondary Insurance Co.
Policy/Group ID
Bal
Due
X
Code
99203
99204
99205
Service
New Patient
Limited/Simple (30m)
Comprehensive (45m)
Complex (60m)
99243
99244
99245
New Patient Consult
(Need Referring MD)
Brief (40m)
Full Consult (60m)
Very Complex (80m)
99211
99212
99213
99214
99215
Established Patient
Nurse Visit
Very Brief FU (10m)
Limited/Simple FU (15m)
Comprehensive FU (25m)
Complex FU (40m)
99274
99275
New Cons. 2nd Opin.
Moderate 2nd Opinion
Complex 2nd Opinion
Location
Cardiologist
99375
J3420
J1940
90724
G0008
Other:
90782
90784
A4615
Next Appointment:
Return in:
Home Health
Home Health 30 days
Drugs:
B-12 Injection
Lasix
Flu (Dx V-04.8)
MC Flu Admin Fee
Misc Rx ___________
IM Injections
IV Injections
O2 Cannula
(Wks)
(Mo)
(Yr)
X
Code
93000
93015
93040
93307
93320
93325
93308
93321
ES
BUB
Service
Office Procedures
EKG w/ Interp
Stress Tread w/ Interp
Rhythm strip w/ Interp
2D Echo Compl.
Doppler Compl.
Color Flow Compl.
2D Echo F/U
Doppler F/U
Stress Echo
Echo/Bubble/Doppler
93268
G0005
G0007
93012
93014
G0016
Event Monitor
Loop- Non MC
Loop - Hookup - MC
Loop - Interp - MC
Chest Plate Tech - Non MC
Chest Pl - Interp Non MC
Chest Pl - Interp MC
93224
Holter Monitor
Holter w/ Interp Global
92960
93734
93735
93731
93732
Other
Cardioversion
Pacer Eval - Single
Pacer Eval - Sngl w/ Prg
Pacer Eval - Dual
Pacer Eval - Dual w/ Prg
99499
99080
Review outside records
Special Reports
BI:
Notes:
Code
Service
Diagnostic w/o Interp
(Technical only)
EKG
Stress Tread
Holter Hookup
Holter Scan
2D Echo
Doppler Compl.
Color Flow
2D Echo F/U
Doppler F/U
Carotid Doppler
93005
93017
93225
93226
93307-TC
93320-TC
93325-TC
93308-TC
93321-TC
93880-TC
Phys
93010
TR
NU
ES-26
307
320-26
325-26
308
321-26
227
71250-26
XXXXX
Interpretation-Supervision,
Interpretation & Report Only
EKG Interp & Reortt only
Regular Stress Test--S, I & R
Nuclear Stress Test--S, I & R
Stress Echocardiogram--S,I & R
Echocardiogram 2-D
Doppler Echocardiogram
Color Flow
Echocardiogram 2-D F/U
Doppler F/U
Holter Monitor - I & R only
UltraFast CT
LAB ORDERED
(see attached sheet)
VeniPuncture (non MC)
Specimen Collection (Lab)
36415
99000
Hospital Admission:
Admit Cath
Admit to ________________unit at:
Before next
appointment:
Ekg
TM
X
Echo
Stress
Echo
Doppler
CFD
CXR
Holter
Event Monitor
Lab
_____________
BAP
Other:
WMC
CMC
SHMC
__________________________
Cardiac Diagnoses
(prioritize by number and circle)
X Code
427.9
426.0
426.12
426.13
427.31
427.32
427.5
785.1
427.60
427.69
427.81
427.0
780.2
785.0
427.41
427.1
426.7
Description
Arrhythmias:
*Arrhythmia
A-V block Complete
A-V block Mobitz II
A-V block Mobitz I / Other
*Atrial Fibrillation
*Atrial Flutter
Cardiac arrest
*Palpitations
*Premature beats
*PVC’s
*Sinoatrial node dysfunction
SVT
Syncope
*Tachycardia (sinus)
*Ventricular Fibrillation
Ventricular tachycardia
WPW (all pre-excitation)
429.2
794.30
413.1
413.9
411.1
414.01
786.50
786.51
786.59
414.8
411.0
V81.0
785.51
785.50
Ischemic Heart Disease
*ASCVD
Abnormal Tread / Nuke / PET
Angina (Prinzmetal)
Angina (Stable)
Angina (Unstable)
CAD
Chest pain, unspecified
Chest pain, precordial
Chest pain, tightness
Chronic Isch. Ht. Dis. specific
Postmyocardial infarct syndrome
Screening for ischemic HD
Shock, cardiogenic
Shock, unspecified
X Code
414.10
Description
Myocardial/Pericardial
Aneurysm of Heart
429.3
425.4
425.1
V81.2
428.0
428.1
401.1
401.0
402.90
402.91
404.92
422.90
420.91
423.2
239.8
*+Cardiomegaly / LVH
*+Cardiomyopathy dilated
*Cardiomyopathy, hypertrophic
Chemo. Tx. Pre/Post
*+CHF - right and left
*CHF - left
Hypertension, benign
Hypertension, malignant
Hypertensive ht. dis w/o CHF
Hypertensive ht. dis. w/ CHF
Hypertensive ht. Dis. W/renal fail
Myocarditis
*Pericarditis, acute
Peridarditis (constrictive)
Tumor (intracardiac)
785.3
424.1
745.5
747.10
421.0
424.0
394.0
394.2
394.9
785.2
747.0
V43.3
996.02
996.61
996.71
424.3
429.5
429.6
424.2
745.4
Valvular Disease / Congenital
*Abnormal heart sounds
*Aortic valve disease
*Atrial septal defect
*Coarctation of aorta
*Endocarditis
*Mitral regurgitation
*Mitral stenosis
*Mitral setnosis w/ insufficiency
*Mitral valve prolapse unspec.
*Murmur
*Patent ductus
*Prosthetic Heart valve
Prosthetic Valve - failure
Prosth Device (valve/pacer)- inftn
Prosth Valve - embolus / thrombus
*+Pulmonic valve disease
*Ruptured Chordae
*Ruptured Papillary m.
*+Tricuspid valve disease
*Ventricular septal defect
X Code
410.0__
410.4__
410.6__
412
410.7__
Myocardial Infarct: 5th digit ( _ ):
1=Initial care; 2= Subsequent care
Anterolateral
Inferior
Posterior
Previous MI
Subdendocardial
All Echos require a DX that begins with an asterisk (*)
All Rt. Heart Caths require DX with a plus (+)
789.0
280.8
281.0
285.9
300.4
715.80
493.20
724.5
786.2
715.90
715.09
250.01
250.00
780.8
558.9
780.4
Abdominal Pain
Anemia, Iron Deficiency
Anemia, Pernicious
Anemia, Unspecified
Anxiety, depression
Arthritis, osteo, Unspec.
Asthma, Chronic w/ COPD
Backache, unspecified
Cough
Degenerative arthritis
Degenerative joint disease
Diabetes (Insulin dep)
Diabetes (NIDDM)
Diaphoresis
Diarrhea
Dizziness/vertigo nos
434.10
434.00
433.10
434.91
785.9
443.9
441.01
451.9
435.9
424.2
435.3
Description
Cerebral / Vascular
Aortic Aneurysm
Autonomic Dys. or
Carotid sinus syndrome
Cerebral Embolism
Cerebral Thrombosis
*Carotid Stenosis
*CVA
Other CV System (Bruit)
Peripheral vascular disease
*Thoracic Aortic Dissection
Thrombophlebitis
*Transient ischemic attack (TIA)
*+Tricuspid valve disease
Vertebrobasilar Insuff.
496.
416.9
415.19
416.0
416.8
799.1
Pulmonary
*COPD
Cor pulmonale
Pulmonary embolism & infarct
*+Pulmonary hypertension (Pri)
*+Pulmonary hypertens. (Second)
Respiratory failure
794.31
861.01
786.09
272.0
272.4
272.1
276.8
959.1
861.02
861.03
V71.7
V70.8
V72.81
V45.01
Other Cardiac
Abnormal EKG
*Contusion Heart w/open wound
Dyspnea
Hypercholesterolemia
Hyperlipidemia
Hypertriglyceridemia
Hypokalemia
Injury to chest wall
*Laceration Heart w/o penetration
*Laceration Heart w/ penetration
Observation (cardiac)
Organ donor exam
Pre-op Cardiac Exam
Cardiac pacemaker in situ
462
451.9
V70.0
511.9
486
485
482.9
518.89
780.6
584.5
584.9
585
780.3
780.02
465.9
599.0
787.01
Pharyngitis
Phelebitis, unspecified site
Physical, routine
Pleurisy
Pneumonia
Pneumonia, bronchial
Pneumonia, bacterial, unspec.
Pulmonary nodule
Pyrexia, unknown origin
Renal failure, acute w/lesion
Renal failure, acute unspecified
Renal failure, chronic
Seizure disorder
Trans all pt awareness
Upper resp tract infect
Urinary tract infect
Vomiting w/Nausea
441.9
337.0
Non-Cardiac Diagnoses
787.2
782.3
492.8
558.9
346.91
307.81
784.0
553.3
600.
V04.8
780.7
787.02
786.02
733.01
729.5
300.01
533.90
Dysphagia
Edema
Emphysema
Gastroenteritis nos
Headache, migrane
Headache, tension
Headache, vascular
Hiatal hernia
Hyperplasia, prostate
Influenza Immunization Needed
Malaise/fatigue/weakness
Nausea w/o vomiting
Orthopnea
Osteoporosis, Senile
Pain in limb
Panic disorder
Peptic ulcer disease