comprehensive patient report ercp provation

What happens if I have ERCP as an outpatient procedure?

If you have ERCP as an outpatient, you will be observed for complications until most of the effects of the medications have worn off before being sent home. You might experience bloating or pass gas because of the air introduced during the examination.

What is ERCP and why is it important?

What is ERCP? Endoscopic retrograde cholangiopancreatography, or ERCP, is a specialized technique used to study the bile ducts, pancreatic duct and gallbladder. Ducts are drainage routes; the drainage channels from the liver are called bile or biliary ducts.

What tests are done before ERCP is performed?

Generally, before ERCP is recommended, blood tests and noninvasive imaging tests such as ultrasound, computed tomographic (CT) scan or magnetic resonance imaging (MRI) are done.

Can ERCP be used to treat biliary and pancreatic ducts?

Several conditions of the biliary or pancreatic ducts can be treated (cured or improved) by therapeutic ERCP techniques that can open the end of the bile duct, remove stones, and place stents (plastic drainage tubes) across obstructed ducts to improve their drainage.

What is ERCP in medical terms?

Get to Know ERCP. An ERCP is a study of the ducts that drain the liver and pancreas. Indications for this procedure include biliary obstruction due to choledocholithiasis or strictures, sphincter of Oddi dysfunction, acute and chronic pancreatitis, pancreatic pseudocysts, pancreatic necrosis, and pancreatic duct strictures.

How does an ERCP work?

In a diagnostic ERCP, the patient is typically sedated with intravenous sedation and analgesia. The doctor inserts the duodenoscope down the esophagus, through the stomach, and into the duodenum. Air is usually pumped through the endoscope to inflate the stomach and duodenum to make the examination easier.

Which organs are involved in CPT?

To assign CPT® codes accurately, first be familiar with the anatomy involved, including that of the stomach, duodenum, liver, gallbladder, pancreas, biliary and pancreatic ducts, and the ampulla of Vater. The liver produces bile, which helps the small intestine digest food.

Is ERCP easier to report?

Endoscopic retrograde cholang iopancreatography (ERCP) is much easier to report than it is to say; but let your guard down and you might slip up when assigning CPT® codes for ERCP-related procedures. Up-to-date coding information on biliary and pancreatic duct stenting procedures, such as that found in the American Medical Association (AMA) article, “THEN and NOW Endoscopic Retrograde Cholangiopancreatography” ( CPT® Assistant, January 2012, volume 22, issue 1, page 11), will help you from getting tongue-tied when these types of procedures cross your desk.

What is ERCP in medicine?

ERCP Is a specialized technique used to study the ducts (drainage routes) of the liver, gallbladder, and pancreas (the drainage channels from the liver are called bile ducts or biliary ducts). When performed by physicians with special training in this procedure, ERCP can be accomplished in 90-95% of patients.

What is ERCP used for?

ERCP is a valuable tool that is used for diagnosis and treatment of many diseases of the pancreas, bile ducts, liver, and gallbladder. Structural abnormalities such as gallstones, tumors, or strictures (obstructing scar tissue) can be shown in detail and biopsies of abnormal tissue can be obtained if necessary.

How to ensure a successful exam?

To ensure a successful exam, please follow all instructions carefully. Failure to accurately and completely prepare for your exam may result in the need for an additional procedure and both procedures will be billed to your insurance. Stop eating solid foods at midnight.

Can ERCP be used to open bile ducts?

Several conditions of the biliary or pancreatic ducts can be treated (cured or improved) by therapeutic ERCP techniques that can open the end of the bile duct, remove stones, and place stents (plastic drainage tubes) across obstructed ducts to improve their drainage. Instructions. Click for Printable Directions.

Why do you need an ERCP?

The most common reason why someone would need an ERCP is because of a blockage of one of these ducts ( often due to gallstones). Generally, prior to ERCP blood tests and noninvasive imaging tests such as ultrasound, computed tomographic (CT) scan or magnetic resonance imaging (MRI) were performed.

What is an endoscopy?

Endoscopy is the examination of an internal body part with an instrument called an endoscope. Endoscopic retrograde cholangiopancreatography (ERCP) is a techniq. It seems to us that you have your JavaScript disabled on your browser. JavaScript is required in order for our site to behave correctly. Please enable JavaScript to use our site.

What is the purpose of an endoscopy?

Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that uses X-ray to view the patient's bile and pancreatic ducts (figure 1). The functions of the common bile duct and the pancreatic duct are to drain the gallbladder, liver, ...

Why is endoscopy called conscious sedation?

This is called "conscious sedation" because you are awake, but the body is relaxed and pain is numbed.

Can you eat before ERCP?

If you are diabetic, adjustments will be made to your morning doses of medication (tablets or insulin) because you cannot eat anything before your ERCP. If you are pregnant, the ERCP should be postponed until after childbirth if possible, but if the procedure is urgent, it can be done safely during pregnancy.

Can you drink liquids after ERCP?

Most people are able to drink clear liquids shortly after the examination. In some cases, blood tests may be done the same day following ERCP. The endoscopist can usually tell the patient the results of their examination right away. If biopsies were taken, the tissue will need to be sent to a lab for analysis.

Is ERCP a serious procedure?

ERCP COMPLICATIONS. ERCP is a safe procedure and serious complications are uncommon. If complications do occur, they are usually mild, and may include the following: ●Pancreatitis (inflammation of the pancreas) is the most frequent complication, occurring in about 3 to 5 percent of people undergoing ERCP.

ERCP Reporting and Documentation

Please review our Terms and Conditions of Use and check box below to share full-text version of article.

Summary

An endoscopic retrograde cholangiopancreatography (ERCP) procedure is not complete until it has been properly documented. A comprehensive report is crucial to ensure the appropriate output of the procedure. This chapter outlines the principles of structured reporting and highlights the recommended minimal requirements.

What is clinical documentation?

Clinical Documentation Improvement (CDI) Starts with Physician Documentation​ 1 Medical coding and billing errors because of inaccurate, misunderstood or incomplete capture of procedure details ​ 2 Strained doctor-patient relationships due to electronic burdens and interruptions that distract from patient care​

What is the best software for clinical documentation?

Start with Provation, the physician's choice for clinical procedure documentation software. With Provation clinical documentation software, you can solve common issues with physician documentation. That means no more: Misinterpretation of procedure notes and findings due to illegible handwriting or poor transcription​.

Is EHR documentation the same as provation?

EHR clinical documentation doesn't compare to Provation. Electronic health record (EHR) companies often tout an "all-in-one" solution, even though many EHR clinical documentation modules may be inefficient or incomplete. Before choosing to document endoscopy procedures in your EHR instead of Provation, know what questions to ask the vendor.

What Is An ERCP?

• ERCP Is a specialized technique used to study the ducts (drainage routes) of the liver, gallbladder, and pancreas (the drainage channels from the liver are called bile ducts or biliary ducts). When performed by physicians with special training in this procedure, ERCP can be accomplished in 90-95% of patients. ERCP is a valuable tool that is used fo...

See more on digestivehealthcare.net

Pre-Procedure Checklist

Day of Examination

Preparation