DOCSLIB.ORG

Case Log Coding Guidelines Review Committee for Otolaryngology ACGME

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Case Log Coding Guidelines Review Committee for Otolaryngology ACGME Case Log Coding Guidelines Review Committee for Otolaryngology ACGME The following Case Log Coding Guidelines have been provided in an attempt to establish some degree of uniformity for all otolaryngology residents for logging cases into the ACGME Case Log System. The Review Committee for Otolaryngology publicly thanks and credits the Harvard otolaryngology residency program, for drafting the initially proposed document that was utilized in the development of these guidelines, and the University of Michigan program for the most recent revisions. Please note that these guidelines additionally provide role definitions for Resident Surgeon, Resident Assistant, and Resident Supervisor, and demarcate those procedural codes that define Key Indicator Cases (as indicated by red asterisks *). These cases constitute the 14 procedure categories identified by the Review Committee to be representative of otolaryngology surgical education. Also included are instructions for the proper un-bundling of procedures (as indicated by blue text) for Case Log recording (but not billing) purposes. This document contains a linkable Table of Contents for electronic use, but is also designed to print in booklet form (pages 2-9). This document will be periodically updated by the Review Committee for Otolaryngology based on updates to key indicator cases and procedures. Program directors will be notified of such updates via the ACGME e-Communication or other correspondence. 1 ©2012 Accreditation Council for Graduate Medical Education (ACGME) Table of Contents GENERAL/ENDOSCOPY/RHINOLOGY ......................................................................... 2 Emergency Department Procedures ........................................................................... 2 Post-operative Complications ..................................................................................... 3 Endoscopy: Airway and Foreign Body Procedures ..................................................... 3 Sinus Surgery ............................................................................................................. 3 General/Pediatric ........................................................................................................ 4 PEDIATRIC OTOLARYNGOLOGY ................................................................................. 4 LARYNGOLOGY ............................................................................................................ 4 HEAD and NECK SURGERY ......................................................................................... 5 Endocrine Surgery ...................................................................................................... 5 Neck Dissection .......................................................................................................... 5 Salivary Gland Procedures ......................................................................................... 5 Oral Cavity/Oropharynx .............................................................................................. 5 Laryngectomy ............................................................................................................. 6 Anterior Craniofacial Resection ................................................................................... 6 Maxillectomy ............................................................................................................... 6 Excision of Cutaneous Facial Lesion .......................................................................... 6 Head and Neck Ablative Procedures .......................................................................... 6 FACIAL PLASCTIC AND RECONSTRUCTIVE SURGERY ............................................ 7 Free/Pedicled Flaps .................................................................................................... 7 Plastics/Trauma Procedures ....................................................................................... 7 Microtia Repair ............................................................................................................ 8 OTOLOGY/NEUROTOLOGY ......................................................................................... 9 Otology ....................................................................................................................... 9 Ablative Otologic Procedures ...................................................................................... 9 Reconstructive Otologic Procedures ........................................................................... 9 Appendix: Key Indicator Categories ............................................................................. 10 laceration repair: *Asterisk by key indicator cases <1.0 cm: 13150 Rules for unbundling noted in blue 1.1-2.5 cm: 13151 2.6-7.5 cm: 13152 Role Definitions: Each additional 5cm Resident surgeon: performs ≥ 50% of the operation (code separate): 13153 with the attending physician or resident supervisor, Open repair frontal sinus fracture: including the key portions of the procedure Depressed: 21343 Resident assistant: performs < 50% of the operation, Complicated: 21344 or ≥ 50% of the operation but not the key portions of Oral vestibule laceration repair: the procedure. ≤2.5cm: 40830 Resident supervisor: instructs/assists a more junior >2.5cm: 40831 resident during a procedure in which the junior FOM/Oral tongue laceration repair: resident performs ≥ 50% of the operation, including the ≤2.5cm: 41250 key portions of the procedure; the attending physician >2.5cm 41252 acts as an assistant or observer. Flexible laryngoscopy, diagnostic: 31575 Flexible laryngoscopy, w/biopsy: 31576 GENERAL/ENDOSCOPY/RHINOLOGY *Flexible laryngoscopy, FB removal: 31577 * Flexible laryngoscopy, lesion removal: 31577 Emergency Department Procedures: Peritonsillar abscess drainage: 42700 Repair complex scalp laceration: Removal impacted cerumen: 69210 1.1-2.5cm: 13120 Removal foreign body from ear: 69200 2.6-7.5cm: 13121 Under GA (operative): 69205 Each additional 5cm Removal of foreign body from nose: 30300 (code separate): 13122 Under GA (operative): 30310 Repair complex forehead/face laceration: 1.1-2.5cm: 13131 Epistaxis Control 2.6-7.5cm: 13132 Anterior epistaxis control (simple): 30901 Each additional 5cm Anterior epistaxis control (complex): 30903 (code separate): 13133 Posterior packing placement: 30905 Repair complex eyelid/ear/nose or lip Revision posterior packing: 30906 2 ©2012 Accreditation Council for Graduate Medical Education (ACGME) Ethmoid artery ligation: 30915 *Bronchoscopy w/FB removal: 31635 Internal maxillary ligation, transantral: 30920 DL w open reduction of fracture: 31584 Endoscopic control, operative: 31238 *DL with dilation, initial: 31528 Septal hematoma/abscess drainage: 30000 *subsequent: 31529 Auricle hematoma/abscess: 69000 *Bronchoscopy w/dilation: 31630 Oral vestibule drainage of cyst, abscess, *Bronchoscopy w/stent placement: 31631 hematoma: *Revision 31638 Simple: 40800 *Bronchoscopy w/tumor excision: 31640 Complicated 40801 *Bronchoscopy w/tumor or stenosis Intraoral I&D abscess/cyst/hematoma: laser ablation: 31641 Lingual: 41000 *Tracheobronchoscopy through Sublingual; superficial: 41005 tracheostomy incision: 31615 Sublingual; deep: 41006 Esophagoscopy, diagnostic: 43200 Submental: 41007 Esophagoscopy, Submandibular space: 41008 w/submucosal injection: 43201 Sublingual/Submaxillary: 42310 w/biopsy: 43202 Masticator space: 41009 w/tumor removal 43217 Extraoral I&D abscess/cyst/hematoma: w/insertion of stent/tube 43219 Sublingual: 41015 w/dilation over guidewire 43226 Submental: 41016 Esophageal dilation Submandibular space: 41017 w/balloon 43220 Masticator space: 41018 w/bougie: 43450 Parotid abscess I&D; simple: 42300 over guidewire: 43453 Parotid abscess I&D; complicated: 42305 retrograde: 45456 Retropharyngeal/parapharyngeal PEG/ G-tube placement: 43246 abscess I&D; intraoral: 42720 Nasopharyngeal biopsy: 42806 Retropharyngeal/parapharyngeal Zenker’s: abscess I&D; extraoral: 42725 (endoscopic) 43499 (open) 43130 Post-operative Complications: (open cricopharyngeal- Neck exploration for hematoma: 35800 myotomy) 43030 Post-operative tonsil bleed requiring OR: 42962 Transcervical repair of esophageal I&D superficial abscess: 10060 wound/injury (open): 43410 I&D deep space hematoma or abscess: 21501 Sinus Surgery (log each side separately): Endoscopy: Airway/Foreign Body Procedures: Insertion of nasal button: 30220 DL, diagnostic: 31525 Removal of FB; lateral rhinotomy: 30320 DL w/biopsy: 31535 Lysis of intranasal synechiae: 30560 DL w/arytenoidectomy: 31560 Endo maxillary antrostomy: 31256 MicroDL w/arytenoidectomy: 31561 Endo maxillary antrostomy + tissue: 31267 Tracheoscopy or microlaryngoscopy Endo frontal +/- tissue: 31276 with biopsy: 31536 Endo sphenoid: 31287 *Bronchoscopy, diagnostic: 31622 Endo sphenoid + tissue: 31288 *Bronchoscopy with BAL: 31624 Endo biopsy or polyp or debridement: 31237 *Bronchoscopy with biopsy: 31625 Endo concha bullosa: 31240 Awake fiberoptic intubation or DCR: emergency intubation: 31500 Endo 31239 Cricoidotomy: 31605 Open/fistulization 68720 Tracheotomy, planned: 31600 *Endo Ant ethmoid: 31254 Tracheotomy, emergency: 31603 *Endo total ethmoid: 31255 Tracheal repair: 31800 Endo diag., maxillary b inf meatus: 31233 *DL with FB removal: 31530 Endo nasal: 31231 Micro DL, diagnostic: 31526 Endo CSF leak repair: *Micro DL w/FB removal: 31531 Ethmoid region: 31290 Removal FB pharynx: 42809 Sphenoid region: 31291 Esophagoscopy w/FB removal: 43215 CSF leak repair
Load more

Recommended publications
  • Septoplasty, Rhinoplasty, Septorhinoplasty, Turbinoplasty Or
    Septoplasty, Rhinoplasty, Septorhinoplasty, 4 Turbinoplasty or Turbinectomy CPAP • If you have obstructive sleep apnea and use CPAP, please speak with your surgeon about how to use it after surgery. Follow-up • Your follow-up visit with the surgeon is about 1 to 2 weeks after Septoplasty, Rhinoplasty, Septorhinoplasty, surgery. You will need to call for an appointment. Turbinoplasty or Turbinectomy • During this visit any nasal packing or stents will be removed. Who can I call if I have questions? For a healthy recovery after surgery, please follow these instructions. • If you have any questions, please contact your surgeon’s office. Septoplasty is a repair of the nasal septum. You may have • For urgent questions after hours, please call the Otolaryngologist some packing up your nose or splints which stay in for – Head & Neck (ENT) surgeon on call at 905-521-5030. 7 to 14 days. They will be removed at your follow up visit. When do I need medical help? Rhinoplasty is a repair of the nasal bones. You will have a small splint or plaster on your nose. • If you have a fever 38.5°C (101.3°F) or higher. • If you have pain not relieved by medication. Septorhinoplasty is a repair of the nasal septum and the nasal bone. You will have a small splint or plaster cast on • If you have a hot or inflamed nose, or pus draining from your nose, your nose. or an odour from your nose. • If you have an increase in bleeding from your nose or on Turbinoplasty surgery reduces the size of the turbinates in your dressing.
    [Show full text]
  • Ct Maxillofacial with Contrast Protocol
    Ct Maxillofacial With Contrast Protocol Untrue Blaine ferment retrally and encouragingly, she nogged her Narva jeweling smokelessly. Unsaluted Zak scollop: he bards his self-sacrifice lordly and trichotomously. Eliott companions perdurably. In contrast both ultra-low dose protocols that combined a larger voxel. Although some elements on maxillofacial lesions in protocol change was limited in addition, protocols were reported are extremely thin slices. Contact us see it kills thyroid functions, which are related disorders such as they safe. CT The American College of Radiology with regret than. If the protocol is changed by one then our radiologists to condition more suitable. PRACTICE PARAMETER CT American College of Radiology. Assume that ct? Separate requests for concurrent imaging of the arteries and the veins in separate head are inappropriate. You have had an hour prior to maxillofacial fibrosarcoma using special room, protocol is no additional effects research to help your details. Patient lead a candidate for curative surgery. No citing articles found no other precautions can be stored in your email address ct maxillofacial radiology facilities may affect your contrast ct with maxillofacial lesions. Pillows may est will usually, with maxillofacial ct with persistent dysesthesia as radiation. It personnel also used to narrate at blood vessels and lymph nodes in the abdomen. RESULTS Compared with the reference dose protocol with FBP the. MRI lumbar spine pain and without IV contrast is best appropriate; CT lumbar spine system or without IV contrast can be performed if MRI is contraindicated. Ordered CT exams under ARA protocols For any coding. Studies by maxillofacial with other.
    [Show full text]
  • Comparison of the Effects of Dexmedetomidine Versus Fentanyl
    Current Therapeutic Research Volume 70, Number 3, June 2009 Comparison of the Effects of Dexmedetomidine Versus Fentanyl on Airway Reflexes and Hemodynamic Responses to Tracheal Extubation During Rhinoplasty: A Double-Blind, Randomized, Controlled Study Recep Aksu, MD; Aynur Akın, MD; Cihangir Biçer, MD; Aliye Esmaoglu,˘ MD; Zeynep Tosun, MD; and Adem Boyacı, MD Department of Anesthesiology, Erciyes University School of Medicine, Kayseri, Turkey ABSTRACT Background: Stimulation of various sites, from the nasal mucosa to the dia- phragm, can evoke laryngospasm. To reduce airway reflexes, tracheal extubation should be performed while the patient is deeply anesthetized or with drugs that do not depress ventilation. However, tracheal extubation during rhinoplasty may be dif- ficult because of the aspiration of blood and the possibility of laryngospasm. Dexmede- tomidine and fentanyl both have sedative and analgesic effects, but dexmedetomidine has been reported to induce sedation without affecting respiratory status. Objective: The aim of this study was to compare the effects of dexmedetomi- dine and fentanyl on airway reflexes and hemodynamic responses to tracheal extuba- tion in patients undergoing rhinoplasty. Methods: This double-blind, randomized, controlled study was conducted at the Erciyes University Medical Center, Kayseri, Turkey. Patients classified as Ameri- can Society of Anesthesiologists physical status I or II who were undergoing elective rhinoplasty between January 2007 and June 2007 with general anesthesia were eli- gible for study entry. Using a sealed-envelope method, the patients were randomly divided into 2 groups (20 patients per group). Five minutes before extubation, pa- tients received either dexmedetomidine 0.5 μg/kg in 100 mL of isotonic saline or fentanyl 1 μg/kg in 100 mL of isotonic saline intravenously.
    [Show full text]
  • Rhinoplasty and Septorhinoplasty These Services May Or May Not Be Covered by Your Healthpartners Plan
    Rhinoplasty and septorhinoplasty These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. Administrative Process Prior authorization is not required for: • Septoplasty • Surgical repair of vestibular stenosis • Rhinoplasty, when it is done to repair a nasal deformity caused by cleft lip/ cleft palate Prior authorization is required for: • Rhinoplasty for any indication other than cleft lip/ cleft palate • Septorhinoplasty Coverage Rhinoplasty is not covered for cosmetic reasons to improve the appearance of the member, but may be covered subject to the criteria listed below and per your plan documents. The service and all related charges for cosmetic services are member responsibility. Indications that are covered 1. Primary rhinoplasty (30400, 30410) may be considered medically necessary when all of the following are met: A. There is anatomical displacement of the nasal bone(s), septum, or other structural abnormality resulting in mechanical nasal airway obstruction, and B. Documentation shows that the obstructive symptoms have not responded to at least 3 months of conservative medical management, including but not limited to nasal steroids or immunotherapy, and C. Photos clearly document the structural abnormality as the primary cause of the nasal airway obstruction, and D. Documentation includes a physician statement regarding why a septoplasty would not resolve the airway obstruction. 2. Secondary rhinoplasty (30430, 30435, 30450) may be considered medically necessary when: A. The secondary rhinoplasty is needed to treat a complication/defect that was caused by a previous surgery (when the previous surgery was not cosmetic), and B.
    [Show full text]
  • Large Animal Surgical Procedures As-Of December 1, 2020 Abdominal
    Large Animal Surgical Procedures as-of December 1, 2020 Core Curriculum Category Surgical Category Surgical Procedure Diaphragmatic herniorrhaphy Exploratory celiotomy - left flank Exploratory celiotomy - right flank Abdominal cavity/wall Exploratory celiotomy - ventral midline Exploratory celiotomy - ventral paramedian Exploratory laparotomy - death / euthanasia on table Peritoneal lavage via celiotomy Cecocolostomy Ileo-/Jejunocolostomy Cecum Jejunocecostomy Typhlectomy, partial Typhlotomy Abomasopexy, laparoscopic Abomasopexy, left flank Abdominal - LA Abomasopexy, paramedian Food animal GI: Abomasum Abomasotomy Omentopexy Pyloropexy, flank Reduction of volvulus Typhlectomy Food animal GI: Cecum Typhlotomy Food animal GI: Descending colon, Rectal prolapse, amputation/anastomosis rectum Rectal prolapse, submucosal reduction Food animal GI: Rumen Rumenotomy Decompression/emptying (no enterotomy) Food animal GI: Small intestine Enterotomy Reduction w/o resection (incarceration, volvulus, etc.) Resection/anastomosis Enterotomy Reduction of displacement Food animal GI: Spiral colon Reduction of volvulus Resection/anastomosis (inc. atresia coli) Side-side anastomosis, no resection Colopexy, hand-sutured Colopexy, laparoscopic Colostomy Large colon Enterotomy Reduction of displacement Reduction of volvulus Resection/anastomosis Biopsy Liver Cholelith removal Liver lobectomy Laceration repair Rectum Rectal prolapse repair Resection/anastomosis Enterotomy Impaction resolution via celiotomy Small colon Resection/anastomosis Taeniotomy Decompression/emptying
    [Show full text]
  • Rhinoplasty ARTICLE by PHILIP WILKES, CST/CFA
    Rhinoplasty ARTICLE BY PHILIP WILKES, CST/CFA hinoplasty is plastic become lodged in children's noses.3 glabella, laterally with the maxilla, surgery of the nose Fortunately, the art and science of inferiorly with the upper lateral car- for reconstructive, rhinoplasty in the hands of a skilled tilages, and posteriorly with the eth- restorative, or cos- surgical team offers positive alter- moid bone? metic purposes. The natives. The nasal septum is formed by procedure of rhmo- Three general types of rhino- the ethmoid (perpendicular plate) plasty had its beginnings in India plasty will be discussed in this arti- and vomer bones (see Figure 5). The around 800 B.c.,as an ancient art cle. They include partial, complete, cartilaginous part is formed by sep- performed by Koomas Potters.' and finesse rhinoplasties. tal and vomeronasal cartilages. The Crimes were often punished by the anterior portion consists of the amputation of the offender's nose, Anatomy and Physiology of the medial crus of the greater alar carti- creating a market for prosthetic sub- Nose lages, called the columella nasi? stitutes. The skill of the Koomas The nose is the olfactory organ that The vestibule is the cave-like area enabled them to supply this need. In projects from the center of the face modem times, rhinoplasty has and warms, filters, and moistens air developed into a high-technology on the way to the respiratory tract. procedure that combines art with Someone breathing only through the latest scientific advancements.' the mouth delivers a bolus of air During rhinoplastic procedures, with each breath. The components surgeons can change the shape and of the nose allow a thin flow of air size of the nose to improve physical to reach the lungs, which is a more appearance or breathing.
    [Show full text]
  • Diagnostic Nasal/Sinus Endoscopy, Functional Endoscopic Sinus Surgery (FESS) and Turbinectomy
    Medical Coverage Policy Effective Date ............................................. 7/10/2021 Next Review Date ....................................... 3/15/2022 Coverage Policy Number .................................. 0554 Diagnostic Nasal/Sinus Endoscopy, Functional Endoscopic Sinus Surgery (FESS) and Turbinectomy Table of Contents Related Coverage Resources Overview .............................................................. 1 Balloon Sinus Ostial Dilation for Chronic Sinusitis and Coverage Policy ................................................... 2 Eustachian Tube Dilation General Background ............................................ 3 Drug-Eluting Devices for Use Following Endoscopic Medicare Coverage Determinations .................. 10 Sinus Surgery Coding/Billing Information .................................. 10 Rhinoplasty, Vestibular Stenosis Repair and Septoplasty References ........................................................ 28 INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies. Please note, the terms of a customer’s particular benefit plan document [Group Service Agreement, Evidence
    [Show full text]
  • Study Guide Medical Terminology by Thea Liza Batan About the Author
    Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails ­proficiency­in­communicating­with­healthcare­professionals­such­as­physicians,­nurses,­ or dentists.
    [Show full text]
  • Surgical Management of Nasal Airway Obstruction
    Surgical Management of Nasal Airway Obstruction John F. Teichgraeber, MDa, Ronald P. Gruber, MDb, Neil Tanna, MD, MBAc,* KEYWORDS Nasal obstruction Nasal breathing Septal deviation Nasal valve narrowing Turbinate hypertrophy KEY POINTS The management and diagnosis of nasal airway obstruction requires an understanding of the form and function of the nose. Nasal airway obstruction can be structural, physiologic, or a combination of both. Anatomic causes of airway obstruction include septal deviation, internal nasal valve narrowing, external nasal valve collapse, and inferior turbinate hypertrophy. Thus, the management of nasal air obstruction must be selective and carefully considered. The goal of surgery is to address the deformity and not just enlarge the nasal cavity. INTRODUCTION vomer, and maxillary crest. The narrowest portion of the nose is the internal nasal valve (10–15), The management and diagnosis of nasal airway which is formed by the septum, the inferior turbi- obstruction requires an understanding of the nate, and the upper lateral cartilage. Short nasal form and function of the nose. Nasal airway bones, a narrow midnasal fold, and malposition obstruction can be structural, physiologic, or a of the alar cartilages all predispose patients to in- combination of both. Thus, the management of ternal valve incompetence. nasal airway obstruction must be selective and The lateral wall of the nose contains 3 to 4 turbi- often involves medical management. The goal of nates (inferior, middle, superior, supreme) and the surgery is to address the deformity and not just corresponding meatuses that drain the paranasal enlarge the nasal cavity. This article reviews airway sinuses. The nasolacrimal duct drains through obstruction and its treatment.
    [Show full text]
  • Diagnostic Direct Laryngoscopy, Bronchoscopy & Esophagoscopy
    Post-Operative Instruction Sheet Diagnostic Direct Laryngoscopy, Bronchoscopy & Esophagoscopy Direct Laryngoscopy: Examination of the voice box or larynx (pronounced “lair-inks”) under general anesthesia. An instrument called a laryngoscope is carefully placed into the mouth and used to visualize the larynx and surrounding structures. Bronchoscopy: Examination of the windpipe below the voice box in the neck and chest under general anesthesia. A long narrow telescope is passed through the larynx and used to carefully inspect the structures of the trachea and bronchi. Esophagoscopy: Examination of the swallowing pipe in the neck and chest under general anesthesia. An instrument called an esophagoscope is passed into the esophagus (just behind the larynx and trachea) and used to visualize the mucus membranes and surrounding structures of the esophagus. Frequently a small biopsy is taken to evaluate for signs of esophageal inflammation (esophagitis). What to Expect: Diagnostic airway endoscopy procedures generally take about 45 minutes to complete. Usually the procedure is well-tolerated and the child is back-to-normal the next day. Mild throat or tongue discomfort may persist for a few days after the procedure and is usually well-controlled with over-the-counter acetaminophen (Tylenol) or ibuprofen (Motrin). Warning Signs: Contact the office immediately at (603) 650-4399 if any of the following develop: • Worsening harsh, high-pitched noisy-breathing (stridor) • Labored breathing with chest retractions or flaring of the nostrils • Bluish discoloration of the lips or fingernails (cyanosis) • Persistent fever above 102°F that does not respond to Tylenol or Motrin • Excessive coughing or respiratory distress during feeding • Coughing or throwing up bright red blood • Excessive drowsiness or unresponsiveness Diet: Resume baseline diet (no special postoperative diet restrictions).
    [Show full text]
  • Donald C. Lanza MD, FACS
    Publications By: Donald C. Lanza MD, FACS Original Papers: 1. Lanza DC; Koltai PJ; Parnes SM; Decker JW; Wing P; Fortune JB.: Predictive value of the Glasgow Coma Scale for tracheotomy in head-injured patients. Ann Otol Rhinol Laryngol 1990 Jan;99(1):38-41 2. Lanza DC; Parnes SM; Koltai PJ; Fortune JB.: Early complications of airway management in head-injured patients. Laryngoscope 1990 Sep; 100(9):958-61 3. Piccirillo JF; Lanza DC; Stasio EA; Moloy PJ.: Histiocytic necrotizing lymphadenitis (Kikuchi's disease). Arch Otolaryngol Head Neck Surg 1991 Jul;117(7):800-2 4. Lanza DC; Kennedy DW; Koltai PJ.: Applied nasal anatomy & embryology. Ear Nose Throat J 1991 Jul;70(7):416-22 5. Kennedy, D.W., & Lanza D.C.: “Technical Problems in Endoscopic Sinus Surgery.” Journal of Japanese Rhinologic Soc. 30.1, 60-61, 1991. 6. Lanza DC; Kennedy DW.: Current concepts in the surgical management of chronic and recurrent acute sinusitis. J Allergy Clin Immunol 1992 Sep;90(3 Pt 2):505-10; discussion 511 7. Lanza DC; Kennedy DW.: Current concepts in the surgical management of nasal polyposis. J Allergy Clin Immunol 1992 Sep;90(3 Pt 2):543-5; discussion 546 8. Kennedy DW; Lanza DC.: Technical problems in endoscopic sinus surgery. Rhinol Suppl 1992;14:146-50 9. Lanza, D.C., Farb-Rosin, D., Kennedy, D.W.: “Endoscopic Septal Spur Resection.” American Journal of Rhinology, 7:5, 213-216, October 1993. 10. Lanza, D.C. Kennedy, D.W.: “Chronic Sinusitis: When is Surgery Needed?” Clinical Focus: Patient Care, 25-32, December 1993.
    [Show full text]
  • ANMC Specialty Clinic Services
    Cardiology Dermatology Diabetes Endocrinology Ear, Nose and Throat (ENT) Gastroenterology General Medicine General Surgery HIV/Early Intervention Services Infectious Disease Liver Clinic Neurology Neurosurgery/Comprehensive Pain Management Oncology Ophthalmology Orthopedics Orthopedics – Back and Spine Podiatry Pulmonology Rheumatology Urology Cardiology • Cardiology • Adult transthoracic echocardiography • Ambulatory electrocardiology monitor interpretation • Cardioversion, electrical, elective • Central line placement and venous angiography • ECG interpretation, including signal average ECG • Infusion and management of Gp IIb/IIIa agents and thrombolytic agents and antithrombotic agents • Insertion and management of central venous catheters, pulmonary artery catheters, and arterial lines • Insertion and management of automatic implantable cardiac defibrillators • Insertion of permanent pacemaker, including single/dual chamber and biventricular • Interpretation of results of noninvasive testing relevant to arrhythmia diagnoses and treatment • Hemodynamic monitoring with balloon flotation devices • Non-invasive hemodynamic monitoring • Perform history and physical exam • Pericardiocentesis • Placement of temporary transvenous pacemaker • Pacemaker programming/reprogramming and interrogation • Stress echocardiography (exercise and pharmacologic stress) • Tilt table testing • Transcutaneous external pacemaker placement • Transthoracic 2D echocardiography, Doppler, and color flow Dermatology • Chemical face peels • Cryosurgery • Diagnosis
    [Show full text]