OPCS-4.8 to OPCS-4.9 Summary of Core Changes Contents
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Lower Gastrointestinal Bleeding
Journal of Experimental and Clinical Medicine https://dergipark.org.tr/omuJecm Re view Article J Exp Clin Med 2021; 38(S1): 23-32 doi: 10.52142/omujecm.38.si.gastro.3 Lower gastrointestinal bleeding Serkan ÖCAL1,* , Mehmet Mutlu ÇATLI2 1 Department of Gastroenterology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey 2Departmant of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey Received: 13.12.2020 • Accepted/Published Online: 09.01.2021 • Final Version: 18.03.2021 Abstract Bleeding from the lower part of the digestive system that appears as hematocheZia (fresh blood, clot or cherry-colored stool) or melena (dark- colored tarry stool) is called lower gastrointestinal tract bleeding (lower GI bleeding) (or colonic bleeding). In the traditional definition, lower GI bleeding was generally classified as bleeding distal to the TreitZ ligament (duodenojejunal junction) as the border. In the last decade, GI bleeding has adopted three categories in some recent publications: Upper, middle, and lower. According to this category, bleeding from a source between the TreitZ ligament and the ileocecal valve is classified as middle GI bleeding, bleeding from the distal of the ileocecal valve is classified lower GI bleeding. Lower GI bleeding and hospitalization rates increase with aging. Currently, physicians managing lower GI bleeding have many different diagnostic and therapeutic options ranging from colonoscopy and flexible sigmoidoscopy to radiographic interventions such as scintigraphy or angiography. Lower GI bleeding often stops spontaneously and less common than upper GI bleeding. Even though no modality has emerged as the gold standard in the treatment of lower GI bleeding, colonoscopy has several advantages and is generally considered as the preferred initial test in most of the cases. -
Outpatient Services
Outpatient Services Coverage of Certain Services in the OUTPATIENT setting only* EFFECTIVE MARCH 9, 2015 bmchp.org | 888-566-0008 TO FIND A CODE OR WORD - While holding down the CTRL key, press the F key, type in Code, then press ENTER key Procedure Code Description 0213T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; single level 0214T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; second level (List separately in addition to code for primary procedure) 0215T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; third and any additional level(s) (List separately in addition to code for primary procedure) 0216T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level 0217T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; second level (List separately in addition to code for primary procedure) 0218T Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound -
Regions Hospital Delineation of Privileges Surgery
Regions Hospital Delineation of Privileges Surgery Applicant’s Name: ____________________________________________________________________________ Last First M. Instructions: Place a check-mark where indicated for each core group you are requesting. Review education and basic formal training requirements to make sure you meet them. Review documentation and experience requirements and be prepared to prove them. Note all renewing applicants are required to provide evidence of their current ability to perform the privileges being requested\ When documentation of cases or procedures is required, attach said case/procedure logs to this privileges-request form. Provide complete and accurate names and addresses where requested -- it will greatly assist how quickly our credentialing-specialist can process your requests. Overview: (Applicant should check all core privileges you are requesting) Core I – General Staff Privileges in Surgery Core II – General Staff Privileges in Trauma (Adult and Pediatric) Core III – Pediatric Trauma Rounding Privileges Core IV – General Staff Privileges in Burn Core V – General Staff Privileges in Colon and Rectal Surgery Core VI – General Staff Privileges in Vascular Surgery Core VII – General Staff Privileges in Surgical Critical Care Special Privileges Also included are: Core Procedure Lists Signature Page Page 1 of 24 06.2015 CORE I -- General Staff Privileges in Surgery (Appointments are based on the needs of the Department of Surgery as determined by the Division Head of Surgery and Hospital Board) Privileges Privileges include the performance of surgical procedures (including related admission, consultation, work-up, pre- and post-operative care) to correct or treat various conditions, illnesses and injuries of the: alimentary tract, including colon and rectum, abdomen and its contents, breasts, skin, and soft tissue, head and neck, endocrine system and vascular system, excluding the intercranial vessels, the heart and those vessels intrinsic and immediately adjacent thereto. -
Anal Cancer Anal Cancer, Also Known As Anal Carcinoma, Is Cancer of the Anus
Anal Cancer Anal cancer, also known as anal carcinoma, is cancer of the anus. To help diagnose this condition, your doctor will perform a digital rectal exam and anoscopy. An MRI, CT, PET/CT, or an endoanal ultrasound may also be ordered by your doctor. Depending on the size, location, and extent of the cancer, treatments may include surgery, radiation therapy and chemotherapy. What is anal cancer? Anal cancer is a cancer that begins in the anus, the opening at the end of the gastrointestinal tract through which stool, or solid waste, leaves the body. The anus begins at the bottom of the rectum, which is the last part of the large intestine (also called the colon). Anal cancer usually affects adults over age 60 and women more often than men. More than 8,000 people in the U.S. are diagnosed with anal cancer each year. Anal cancer symptoms may include changes in bowel habits and changes in and around the anal area, including: bleeding and itching pain or pressure unusual discharge a lump or mass fecal incontinence fistulae. Some patients with anal cancers do not experience any symptoms. Some non-cancerous conditions, such as hemorrhoids and fissures, may cause similar symptoms. How is anal cancer diagnosed and evaluated? To diagnose the cause of symptoms, your doctor may perform: Digital rectal examination (DRE): Digital Rectal Exam (DRE): This test examines the lower rectum and the prostate gland in males to check for abnormalities in size, shape or texture. The term "digital" refers to the clinician's use of a gloved lubricated finger to conduct the exam. -
Is Digital Rectal Exam Reliable in Grading Anal Sphincter Defects?
DOI: 10.1590/S0004-28032016000400006 ARQGA/1864 IS DIGITAL RECTAL EXAM RELIABLE IN GRADING ANAL SPHINCTER DEFECTS? Marcelo de Melo Andrade COURA, Silvana Marques SILVA, Romulo Medeiros de ALMEIDA, Miles Castedo FORREST and João Batista SOUSA Received 7/7/2015 Accepted 14/8/2015 ABSTRACT - Background - Anal sphincter tone is routinely assessed by digital rectal examination in patients with fecal incontinence, although its accuracy in detecting sphincter defects or separating competent from incompetent muscles has not been established. Objective - In this setting, we aimed to evaluate the accuracy of digital rectal examination in grading anal defects in order to sepa- rate small from extensive cases as depicted on 3D endoanal ultrasound, using a scoring sphincter defect and correlate anal tone to anal pressures. Methods - Women with fecal incontinence were divided into two groups: small or extensive defects according to the ultrasound scoring system. Sensitivity, specificity, positive and negative predictive values of digital rectal examination in grading global and external sphincter defects were calculated. Anal tone at digital rectal examination was compared to resting and incremen- tal pressures. Results - A cohort of 76 consecutive incontinent women were enrolled. The median Wexner score was 9. Sixty-eight showed sphincter defects on 3D endoanal ultrasound. Anal tone at digital rectal examination was considered abnormal in 62 cases. Abnormal digital rectal examination showed a sensitivity of 90%, specificity of 27.78% in distinguishing small from extensive defects of both sphincters. Five out of eight women with no sphincter defects had only abnormal squeeze tone at digital rectal examination. Abnormal squeeze tone at digital rectal examination had a sensitivity of 65.31% in distinguishing small from extensive external anal sphincter defects. -
Flexible Video-Endsocopic Injection Sclerotherapy for Second and Third Degree Internal Hemorrhoids
Published online: 2019-09-26 ORIGINAL ARTICLE Flexible Video-Endsocopic Injection Sclerotherapy for Second and Third Degree Internal Hemorrhoids Sandeep Nijhawan, Udawat H, Gaurav Gupta, Anil Sharma, Amit Mathur, Bharat Sapra, Subhash Nepalia Department of Gastroenterology, SMS Medical College, Jaipur, Rajasthan, India ABSTRACT Background and objectives: Bleeding from hemorrhoids is the commonest cause of rectal bleeding in adults. Injection sclerotherapy of internal hemorrhoids is one of the non-surgical treatments, and is simple, safe and feasible. Conventionally sclerotherapy is performed with rigid proctoscope which has limitations of maneuverability, narrower field of vision and documentation compared to flexible videoendoscope. Therefore, we assessed the efficacy and safety of video-colonoscopic sclerotherapy for bleeding internal hemorrhides. Methods: Seventy-nine patients of bleeding internal hemorrhoids were subjected to colonoscopic sclerotherapy using 1.5% polidocanol in retroflexed or forward viewing positions. Success of treatment was defined as cessation of bleeding for six weeks. Patients were observed for complications and were followed up regularly for 3 months. Results: A total of 79 evaluable patients, 61 had grade II and 18 had grade III hemorrhoids. There was no statistically significant differences in achieving excellent or good results for control of bleeding between patients with grade II and grade III hemorrhoids (100% vs 94,5%; p>0.05). The number of sessions of sclerotherapy required were significantly more in grade II than grade III hemorrhoids (1.1 ± 0.3 vs 1.3 ± 0.7; p = 0.04). No significant complications were noted except for bloating in ten patients (12.6 %) and rectal pain in 6 (7.6%) patients. -
National Clinical Coding Standards OPCS-4 (2018)
OPCS Classification of Interventions and Procedures Version 4.8 OPCS Classification of Interventions and Procedures Volume I - Tabular List I - Tabular Volume National Clinical Coding Standards OPCS-4 (2018) For more information please visit: Accurate data for quality information systems.digital.nhs.uk/data/clinicalcoding ISBN 978-0-11-323048-8 Terminology and Classifications Delivery Service www.tso.co.uk 9 780113 230488 9923 OPCS 4.8 Vol I Cover v0_2.indd 1-3 31/10/2016 10:00 National Clinical Coding Standards OPCS-4 Accurate data for quality information Produced by: Terminology and Classifications Delivery Service NHS Digital Vantage House 40 Aire Street Leeds LS1 4HT [email protected] http://systems.digital.nhs.uk/data/clinicalcoding Date of issue: April 2018 Copyright © 2018 Health and Social Care Information Centre The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. OPCS-4 CONTENTS Introduction ............................................................................................................................ 3 Data Quality ........................................................................................................................... 7 National Clinical Coding Standards OPCS-4 reference book .............................................. 11 Rules of OPCS-4 ................................................................................................................. 16 Conventions of OPCS-4 ..................................................................................................... -
Endorectal, Endoanal and Perineal Ultrasound
Review Nuernberg Dieter et al. EFSUMB Recommendations for Gastrointestinal … Ultrasound Int Open 2018; 00: 00–00 EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3: Endorectal, Endoanal and Perineal Ultrasound Authors Dieter Nuernberg1,*, Adrian Saftoiu2,*, Ana Paula Barreiros3, Eike Burmester4, Elena Tatiana Ivan2, Dirk-André Clevert5, Christoph F. Dietrich6, Odd Helge Gilja7, Torben Lorentzen8, Giovanni Maconi9, Ismail Mihmanli10, Christian Pallson Nolsoe11, Frank Pfeffer12, Søren Rafael Rafaelsen13, Zeno Sparchez14, Peter Vilmann15, Jo Erling Riise Waage12 Affiliations Key words 1 Medical School Brandenburg Theodor Fontane, endorectal ultrasound, endoanal ultrasound, perineal ultrasound Gastroenterology, Neuruppin, Germany received 07.04.2018 2 Research Center in Gastroenterology and Hepatology, revised 23.11.2018 University of Medicine and Pharmacy Craiova, Craiova, accepted 01.12.2018 Romania 3 Deutsche Stiftung Organtransplantation, Head of Bibliography Organisation Center Middle, Frankfurt, Germany DOI https://doi.org/10.1055/a-0825-6708 4 Department of Internal Medicine/Gastroenterology, Published online: 2019 Sana-Kliniken Lübeck, Lübeck, Germany Ultrasound Int Open 2019; 5: E34–E51 5 Department of Clinical Radiology, Interdisciplinary © Georg Thieme Verlag KG Stuttgart · New York Ultrasound-Center, University of Munich-Grosshadern ISSN 2199-7152 Campus, Munich, Germany 6 Caritas-Krankenhaus, Medizinische Klinik 2, Bad Correspondence Mergentheim, Germany Prof. Adrian Saftoiu 7 National Centre for Ultrasound in Gastroenterology, -
Obstetric Anal Sphincter Injury Detection Using Impedance Spectroscopy with the ONIRY Probe
applied sciences Article Obstetric Anal Sphincter Injury Detection Using Impedance Spectroscopy with the ONIRY Probe Marcel Mły ´nczak 1 , Maciej Rosoł 1 , Antonino Spinelli 2,3 , Adam Dziki 4 , Edyta Wla´zlak 5 , Grzegorz Surkont 5 , Magda Krzycka 5 , Paulina Paj ˛ak 5 , Łukasz Dziki 4 , Michał Mik 4 and Katarzyna Borycka-Kiciak 6,* 1 Faculty of Mechatronics, Institute of Metrology and Biomedical Engineering, Warsaw University of Technology, 02-525 Warsaw, Poland; [email protected] (M.M.); [email protected] (M.R.) 2 Humanitas Clinical and Research Center—IRCCS, 20089 Milan, Italy; [email protected] 3 Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy 4 Department of General and Colorectal Surgery, Medical University of Lodz, 90-647 Lodz, Poland; [email protected] (A.D.); [email protected] (Ł.D.); [email protected] (M.M.) 5 First Department of Gynecology and Obstetrics, Clinic for Gynecological Surgery and Oncology, Medical University of Lodz, 94-029 Lodz, Poland; [email protected] (E.W.); [email protected] (G.S.); [email protected] (M.K.); [email protected] (P.P.) 6 Centre of Postgraduate Medical Education, Department of Colorectal, General and Oncological Surgery, 01-813 Warsaw, Poland * Correspondence: [email protected] Featured Application: Impedance spectroscopy performed using ONIRY can be used to screen for possible obstetric anal sphincter injury just after natural delivery, allowing the start of necessary treatment or rehabilitation. Citation: Mły´nczak,M.; Rosoł, M.; Abstract: Anal sphincter injuries occurring during natural deliveries are often a reason for severe Spinelli, A.; Dziki, A.; Wla´zlak,E.; Surkont, G.; Krzycka, M.; Paj ˛ak,P.; complications, including fecal incontinence. -
Endorectal, Endoanal and Perineal Ultrasound
University of Southern Denmark EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3 Endorectal, Endoanal and Perineal Ultrasound Nuernberg, Dieter; Saftoiu, Adrian; Barreiros, Ana Paula; Burmester, Eike; Ivan, Elena Tatiana; Clevert, Dirk-André; Dietrich, Christoph F; Gilja, Odd Helge; Lorentzen, Torben; Maconi, Giovanni; Mihmanli, Ismail; Nolsoe, Christian Pallson; Pfeffer, Frank; Rafaelsen, Søren Rafael; Sparchez, Zeno; Vilmann, Peter; Waage, Jo Erling Riise Published in: Ultrasound International Open DOI: 10.1055/a-0825-6708 Publication date: 2019 Document version: Final published version Document license: CC BY-NC-ND Citation for pulished version (APA): Nuernberg, D., Saftoiu, A., Barreiros, A. P., Burmester, E., Ivan, E. T., Clevert, D-A., Dietrich, C. F., Gilja, O. H., Lorentzen, T., Maconi, G., Mihmanli, I., Nolsoe, C. P., Pfeffer, F., Rafaelsen, S. R., Sparchez, Z., Vilmann, P., & Waage, J. E. R. (2019). EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3: Endorectal, Endoanal and Perineal Ultrasound. Ultrasound International Open, 5(1), E34-E51. https://doi.org/10.1055/a- 0825-6708 Go to publication entry in University of Southern Denmark's Research Portal Terms of use This work is brought to you by the University of Southern Denmark. Unless otherwise specified it has been shared according to the terms for self-archiving. If no other license is stated, these terms apply: • You may download this work for personal use only. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying this open access version If you believe that this document breaches copyright please contact us providing details and we will investigate your claim. -
Sacral Neuromodulation System Neurostimulator Implant Manual
Sacral Neuromodulation System Neurostimulator Implant Manual Model 1101 Neurostimulator Rx only Axonics®, Axonics Modulation®, Axonics Modulation Technologies® and Axonics Sacral Neuromodulation System® are trademarks of Axonics Modulation Technologies, Inc., registered or pending registration in the U.S. and other countries. Axonics Modulation Technologies, Inc. 26 Technology Drive Irvine, CA 92618 (USA) www.axonicsmodulation.com Tel. +1-877-929-6642 Fax +1-949 396-6321 LABEL SYMBOLS This section explains the symbols found on the product and packaging. Symbol Description Symbol Description Refer to instructions for use (Consult accompanying documents) Axonics Neurostimulator Temperature limitation Axonics Torque Wrench Humidity limitation Neurostimulator default waveform with 14 Hz frequency, 0 mA Pressure limitation amplitude and 210 ms pulse width Do not reuse Neurostimulator default electrode configuration: Electrode 0: Negative (-) Electrode 1: Off (0) Sterilized using Ethylene oxide Electrode 2: Off (0) Electrode 3: Positive (+) Use by Case: Off (0) Authorized representative in the European community Open here Do not use if package is damaged Product Serial Number Do not resterilize For USA audiences only Manufacturer !USA Rx ONLY Caution: U.S. Federal law restricts this device for sale by or on the order of a physician Product Model Number Warning / Caution Manufacturing Date Product Literature Non ionizing electromagnetic radiation Magnetic Resonance (MR) Conditional FCC ID US Federal Communications Commission device identification IC Industry Canada certification number Conformité Européenne (European Conformity). This symbol means This device complies with all applicable Australian Communica- that the device fully complies with AIMD Directive 90/385/EEC R-NZtions and Media Authority (ACMA) regulatory arrangements and (Notified Body reviewed) and RED 2014/53/EU (self-certified) electrical equipment safety requirements 3 TABLE OF CONTENTS LABEL SYMBOLS . -
Evaluation of Diagnostic Accuracy of 3-D Endoanal Ultrasound In
j coloproctol (rio j). 2 0 1 8;3 8(1):9–12 Journal of Coloproctology www.jcol.org.br Original Article Evaluation of diagnostic accuracy of 3-D endoanal ultrasound in perianal fistula in comparison with intraoperative findings a a,∗ b c Ehsan Rahmanian , Mojgan Frootan , Fakhri Anaraki , Elahe Alimadadi , d Mahsa Ramezanpoor a Shahid Beheshti of Medical Sciences, Tehran, Iran b Ayatollah Taleghani Hospital, Surgery Department, Tehran, Iran c Shahid Beheshti of Medical Sciences, Research Institute for Gastroenterology and Liver Diseases, Tehran, Iran d Shahid Sadoughi University of Medical Sciences, Research Center – Treatment of Diabetes, Tehran, Iran a r t a b i c s t l e i n f o r a c t Article history: Objective: Perianal fistula is a common and debilitating disease. The definite treatment is Received 24 May 2017 surgery, identifying of primary and secondary tract, internal opening of fistula has important Accepted 26 August 2017 role in planning of surgical techniques. This study’s goal was to determine the diagnostic Available online 26 November 2017 accuracy of 3-D ultrasound in perianal fistula in comparison with intraoperative findings. Materials and methods: This study is a cross-sectional study. Adult patients (18–85 years old) Keywords: with anal fistula have been selected. 3-D EUS was done for all patients by gastroenterologist. Then surgery was done. Check lists filled by endoscopist and surgeon was studied and data Anal fistula Three dimensional endoscopic analysis was done. ultrasounds Results: The study examined 76 patients, in according to results for kappa coefficient there Surgery was a perfect agreement between 3-D ultrasound results and surgery in internal opening that was 96% (p < 0.001) and concordance was 0.974.