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!