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Michael Amendola, M.D.Vascular FellowAugust 14, 2008
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The Basics
Endoscopy
Trauma
Case studies/Tips
Questions
ACGME websiteCase entry
Raw numbers
The new requirements
Critical care casesNon-operative
Personal experience
www.acgme.org
May of Chief Year
CASE LOG
Resident
Program Director
ACGMERRCETC
Type CPT code or search for operation
Type CPT code or search for operation
4955049550
Total = 750
Chief = 150
As it stands now, the RRC has designated that the group of graduates who start in 2007 – 2008 (i.e. graduate in 2012) will
need a total Major number = 750
However, please be advised that the Board’s requirement is that the 750
will be effective July 1, 2008 so anyone applying for the exam in July
of 2009 must meet the new requirement. 8/7/2008 email - ACGME
750 total major cases
ONLY the minimum!
150 Chief Cases
Teaching Assistant Cases 50 will be counted in the 750 major cases will not count toward the 150 Chief Cases
lap, gastrostomy lap feeding
jejunoscopy lap, inguinal hernialap incisional hernia bariatriclap anti-reflux
lap, gastrostomy lap feeding
jejunoscopy lap, inguinal hernialap incisional hernia bariatriclap anti-reflux
lap enterolysis lap, small/large bowellap renal/adrenallap donor
nephrectomylap splenectomy
lap enterolysis lap, small/large bowellap renal/adrenallap donor
nephrectomylap splenectomy
lap choleappendectomytrauma (49320)
lap choleappendectomytrauma (49320)
Concentrate on this during
your endo rotation
Concentrate on this during
your endo rotation
you can always get
this with PEGs
you can always get
this with PEGs
Two residents cannot take credit as surgeon (chief and/or junior) for a procedure done on
the same patient on the same day. I understand that in the OR different residents may actually perform separate procedures, but the RRC only allows one … whichever
resident enters the case first would be able to get credit.
8/7/2008 email - ACGME
Both count equally
Rigid sig in VA ER for lower GI
bleed
Confirmation for apr/lar
cases
20 Non-operative
10 operative
Need 20 - should have about 125 cases
Need 20 - should have about 125 cases
Easy to do it while you are a PGY-III on
nights!
Easy to do it while you are a PGY-III on
nights!
Need 20 - should have about 125 cases
Need 20 - should have about 125 cases
CPT CODE = 99292
CPT CODE = 99292
Ventilator PickVentilator Pick
Re-enter = 99292Re-enter = 99292
Both picks come up
Both picks come up
Check eitherCheck either
8 hernias
6 appendectomie
s
Kid = age < 13
Nonburn skin grafts•Open TMA sites
•Trauma abdomen•Fasciotomy closure
Nonburn skin grafts•Open TMA sites
•Trauma abdomen•Fasciotomy closure
Counts for both?
Counts for both?
You get credit for both
categories
You get credit for both
categories
Total Number Just 1 Case
Total Number Just 1 Case
Can always go back and place this into the
column you need the credit
Can always go back and place this into the
column you need the credit
Never told how many cases you need to turn in.
Would log every liver as a first assistant case.
If you are given the chance to do part of the dissection and or anastomosis for a kidney would count it
50360 - NO! Just total case number!
50360 - NO! Just total case number!
34803 - YES! Defined Category and total case
number!
34803 - YES! Defined Category and total case
number!
75940 - NO! But does count toward total number
of cases!
75940 - NO! But does count toward total number
of cases!
37620 - YES! Defined Category and total case
number!
37620 - YES! Defined Category and total case
number!
NO! But does count toward total number of
cases!
NO! But does count toward total number of
cases!
Surg Onc/ACC Breast Case = Lumpectomy Sentinel node biopsy Axillary node dissection
19302 mastectomy, partial with axillary lymphadenectomy
19302 mastectomy, partial with axillary lymphadenectomy
38792 – sentinel node injection38525 biopsy of sentinel node
38792 – sentinel node injection38525 biopsy of sentinel node
So why enter the rest of the CPT codes?Answer = life beyond residency!
www.eesedu.com
Establish a method for keeping your own list of cases – stick to it!
Log your cases frequently
Add more CPT codes than you think you need
Keep checking your categories and seek out cases that will fill your needs
Follow the hints
Ask upper level residents
Search google or yahoo for cpt codes
Play with the case log system
Email/call Susan
YES
http://www.surgery.vcu.edu/housestaff/index.html.
GOOD LUCK!
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