1. Michael Amendola, M.D. Vascular Fellow August 14, 2008 * note: use (scroll) down arrow to activate animation

2. The Basics Endoscopy Trauma Case studies/Tips Questions ACGME website Case entry Raw numbers The new requirements Critical care cases Non-operative Personal experience

4. www.acgme.org

5. May of Chief Year CASE LOG Resident Program Director ACGME RRC ETC

10. Type CPT code or search for operation

11. 49550

18. Total = 750 Chief = 150

19. 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 Boards 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

20. 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

22. lap, gastrostomy lap feeding jejunoscopy lap, inguinal hernia lap incisional hernia bariatric lap anti-reflux lap, gastrostomy lap feeding jejunoscopy lap, inguinal hernia lap incisional hernia bariatric lap anti-reflux lap enterolysis lap, small/large bowel lap renal/adrenal lap donor nephrectomy lap splenectomy lap enterolysis lap, small/large bowel lap renal/adrenal lap donor nephrectomy lap splenectomy lap chole appendectomy trauma (49320) lap chole appendectomy trauma (49320)

24. Concentrate on this during your endo rotation you can always get this with PEGs

25. 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

27. Both count equally Rigid sig in VA ER for lower GI bleed Confirmation for apr/lar cases

29. 20 Non-operative 10 operative Need 20 - should have about 125 cases

30. Easy to do it while you are a PGY-III on nights! Need 20 - should have about 125 cases

33. CPT CODE = 99292

35. Ventilator Pick

36. Re-enter = 99292

38. Both picks come up

39. Check either

41. 8 hernias 6 appendectomies Kid = age < 13

42. Nonburn skin grafts Open TMA sites Trauma abdomen Fasciotomy closure Nonburn skin grafts Open TMA sites Trauma abdomen Fasciotomy closure

44. Counts for both? You get credit for both categories

46. Total Number Just 1 Case

48. Can always go back and place this into the column you need the credit

49. 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

50. 50360 - NO! Just total case number!

51. 34803 - YES! Defined Category and total case number!

52. 75940 - NO! But does count toward total number of cases! 37620 - YES! Defined Category and total case number!

53. NO! But does count toward total number of cases!

54. Surg Onc/ACC Breast Case = Lumpectomy Sentinel node biopsy Axillary node dissection 19302 mastectomy, partial with axillary lymphadenectomy 38792 – sentinel node injection 38525 biopsy of sentinel node 38792 – sentinel node injection 38525 biopsy of sentinel node So why enter the rest of the CPT codes? Answer = life beyond residency!

55. www.eesedu.com

56. 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

57. Follow the hints Ask upper level residents Search google or yahoo for cpt codes Play with the case log system Email/call Susan

58. YES http://www.surgery.vcu.edu/housestaff/index.html.

59. GOOD LUCK!