Encounter Type (SBD13):  Abdominal Aortic Endograft Duplex

Clinical Template ID: 625, Name: 0_Presentation of Abdominal Duplex Study Type (VarID=5668)(Recent Data=0) Lookup ID=2248 Lookup Name=Other Study Types Follow-up for Angio Intraoperative Study Non-billable On call - after hours Portable Research Teaching Operative History Procedure (VarID=5076)(Recent Data=0) Date (VarID=5077)(Recent Data=0) Side (VarID=5078)(Recent Data=0) Lookup ID=168 Lookup Name=Procedure Side N/A Right Left Bilateral Group (VarID=5691)(Recent Data=0) Risk Factors Age (VarID=258)(Recent Data=0) Activity Level (VarID=15)(Recent Data=0) Lookup ID=6 Lookup Name=Activity Level Active Life Style Dependent, Complete Dependent, Partial Independent Cardiac Status (VarID=259)(Recent Data=0) LVEF (VarID=709)(Recent Data=0) Unstable Angina (VarID=807)(Recent Data=0) Recent MI (within 30 days) (VarID=808)(Recent Data=0) Atrial Fibrillation (VarID=4548)(Recent Data=0) Carotid Artery Disease (VarID=13)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Diabetes (VarID=4)(Recent Data=0) Lookup ID=61 Lookup Name=Diabetes IDDM adult IDDM juvenile NIDDM No Yes Embolization (VarID=297)(Recent Data=0) Lookup ID=403 Lookup Name=Arterial Emolization Multiple Incidents No Single Incident Yes Fibrinogen Level (mg/dl) (VarID=296)(Recent Data=0) Hyperlipidemia (VarID=9)(Recent Data=0) Lookup ID=113 Lookup Name=Hyperlipidemia None Mild Moderate Severe Yes History of Irradiation (VarID=3982)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes HIV (VarID=72)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Hypertension (VarID=3)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Hypercoagulable State (VarID=12)(Recent Data=0) Lookup ID=112 Lookup Name=Hypercoagulation No Proven, treated Proven, untreated Suspected Yes Liver Disease (VarID=5407)(Recent Data=0) Peripheral Arterial Disease (VarID=516)(Recent Data=0) Lookup ID=502 Lookup Name=PAD Amputation Claudication No Rest Pain/Tissue loss Yes Pulmonary Disease (VarID=11)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Renal Disease (VarID=10)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Smoking (VarID=5)(Recent Data=0) Lookup ID=189 Lookup Name=Smoking Yes No Active Former PPD yrs Weight Loss (VarID=5306)(Recent Data=0) Hormonal Treatment (VarID=298)(Recent Data=0) Previous CVA (VarID=5311)(Recent Data=0) Clinical BP Rt Systolic (mm hg) (VarID=101)(Recent Data=0) Rt Diastolic (mm hg) (VarID=104)(Recent Data=0) Lt Systolic (mm hg) (VarID=102)(Recent Data=0) Lt Diastolic (mm hg) (VarID=105)(Recent Data=0) Abdominal Bruit (VarID=527)(Recent Data=0) Lookup ID=208 Lookup Name=True False No Yes Abdominal Pain (VarID=548)(Recent Data=0) Lookup ID=208 Lookup Name=True False No Yes Enlarged liver (VarID=549)(Recent Data=0) Lookup ID=208 Lookup Name=True False No Yes Enlarged Spleen (VarID=550)(Recent Data=0) Lookup ID=208 Lookup Name=True False No Yes Pulsating mass (Aneurysm) (VarID=551)(Recent Data=0) Lookup ID=208 Lookup Name=True False No Yes Urea (VarID=3763)(Recent Data=0) Creatinine (mg/dl) (VarID=30)(Recent Data=0) Generate Note Options Include Operative History Note (VarID=5684)(Recent Data=0) Include Risk Factor Note (VarID=5679)(Recent Data=0) Clinical Note (VarID=5680)(Recent Data=0) Statements Procedure List Title (VarID=5632)(Recent Data=0) Procedure List All (VarID=5075)(Recent Data=0) Risk Factors Title (VarID=5633)(Recent Data=0) Risk Factors Note (VarID=5074)(Recent Data=0) Clinical Title (VarID=5634)(Recent Data=0) Blood Pressure (VarID=4651)(Recent Data=0) Abdominal Presentation (VarID=4649)(Recent Data=0) Abdominal Urea and Creatinine Text (VarID=5673)(Recent Data=0)

Conclusion Template ID: 635, Name: 0_AAA Endoluminal Graft Findings Summary Aneurysm Neck Diameter (mm) (VarID=262)(Recent Data=0) Length (mm) (VarID=261)(Recent Data=0) Aneurysm Maximum Diameter (cm) (VarID=517)(Recent Data=0) Aneurysm Change (VarID=757)(Recent Data=0) Lookup ID=464 Lookup Name=AneurysmSizeChange (ELG) Decreased Increased No Change Endoleak (VarID=758)(Recent Data=0) Endoleak I (VarID=753)(Recent Data=0) Endoleak II (VarID=754)(Recent Data=0) Flow Pattern (VarID=759)(Recent Data=0) Lookup ID=360 Lookup Name=Endoleak Flow (ELG) Accessory renal-lumbar/IMA Hypogastric-lumbar/IMA Lumbar-IMA Lumbar-lumbar Unidentified Endoleak III (VarID=755)(Recent Data=0) Endoleak IV (VarID=756)(Recent Data=0) Endograft Deformation (VarID=760)(Recent Data=0) Lookup ID=364 Lookup Name=EndoGraft Deformation (ELG) Grade 0 Grade I Grade II Grade IIIa Grade IIIb Stenosis (VarID=761)(Recent Data=0) Stenosis Grade (VarID=763)(Recent Data=0) Lookup ID=1005 Lookup Name=Endograft Stenosis Grade 1 - 49% 50 - 79% 80 - 99% 100% Location (VarID=762)(Recent Data=0) Lookup ID=1004 Lookup Name=Endograft Stenosis Location Left Limb Main Stem Right Limb Right Lower Limb Ankle Pressure (mm hg) (VarID=150)(Recent Data=0) Ankle Arm Index (VarID=152)(Recent Data=0) Pseudoaneurysm (VarID=768)(Recent Data=0) Left Lower Limb Ankle Pressure (mm hg) (VarID=151)(Recent Data=0) Ankle Arm Index (VarID=153)(Recent Data=0) Pseudoaneurysm (VarID=769)(Recent Data=0) Critical results Critical Result Type (VarID=5650)(Recent Data=0) Lookup ID=2243 Lookup Name=Lab Critical Result Type Arteriovenous fistula DVT Highest Limb ABI < .40 ICA Critical Stenosis Mesenteric artery critical stenosis Pseudoaneurysm Renal artery critical stenosis Reported To (VarID=3996)(Recent Data=0) Reported by (VarID=3995)(Recent Data=0) Found Time (VarID=3994)(Recent Data=0) Reported Time (VarID=3998)(Recent Data=0) Reporting Method (VarID=4544)(Recent Data=0) Lookup ID=1992 Lookup Name=Reporting Method email Fax Phone Publish to EMR Free-Text Note (VarID=5307)(Recent Data=0) Next Followup (VarID=730)(Recent Data=0) Lookup ID=657 Lookup Name=Lab Study Next Followup No follow-up is needed One Week Two Weeks Three Weeks One Month Two Months Three Months Six Months One Year Two Years

Risk Factors Template ID: 26, Name: Risk Factors Arteriosclerosis Age (VarID=258)(Recent Data=0) Age Group (VarID=37)(Recent Data=0) Lookup ID=9 Lookup Name=Age >= 80 < 55 55 - 69 70 - 79 Carotid Artery Disease (VarID=13)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Cardiac Status (SVS) (VarID=2)(Recent Data=0) Lookup ID=23 Lookup Name=ASHD Mild Moderate None Severe Yes Diabetes (VarID=4)(Recent Data=0) Lookup ID=61 Lookup Name=Diabetes IDDM adult IDDM juvenile NIDDM No Yes Embolization (VarID=297)(Recent Data=0) Lookup ID=403 Lookup Name=Arterial Emolization Multiple Incidents No Single Incident Yes Fibrinogen Level (mg/dl) (VarID=296)(Recent Data=0) Hyperlipidemia (VarID=9)(Recent Data=0) Lookup ID=113 Lookup Name=Hyperlipidemia None Mild Moderate Severe Yes Cholesterol (mg/dl) (VarID=28)(Recent Data=0) LDL (mg/dl) (VarID=26)(Recent Data=0) Triglycerides (mg/dl) (VarID=29)(Recent Data=0) HDL ((mg/dl) (VarID=27)(Recent Data=0) VLDL (%) (VarID=257)(Recent Data=0) History of Irradiation (VarID=3982)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes HIV (VarID=72)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Hypertension (VarID=3)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Hypercoagulable State (VarID=12)(Recent Data=0) Lookup ID=112 Lookup Name=Hypercoagulation No Proven, treated Proven, untreated Suspected Yes Peripheral Arterial Disease (VarID=516)(Recent Data=0) Lookup ID=502 Lookup Name=PAD Amputation Claudication No Rest Pain/Tissue loss Yes Pulmonary Status (VarID=11)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Renal Disease (VarID=10)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Smoking (VarID=5)(Recent Data=0) Lookup ID=189 Lookup Name=Smoking Yes No Active Former PPD yrs Weight (Kg) (VarID=33)(Recent Data=0)