Sacred Heart Hospital Pensacola

Regular Hours: Sacred Heart Hospital Pensacola - EKG/Echo/Pulmonary/Neurodiagnostics - Monday Friday 8:00 am 4:30 pm Scheduling/Orders: Ph 416-2940 Fax Server: 416-7337 (41-ORDER) Results: See (*1) Ph 416-6800 Option 2 Gerry Burns, RPFT Contact Name(s): Coordinator Cardiopulmonary Sonographer Phone / Fax: Location: Ph: 416-7768 Pgr: 429-3621 Fax: 416-7598 Sherri Pyle, RDCS Chief Cardiac Ph: 416-6801 Pgr: 506-1882 Fax: 416-7598 Mark Cates, R. NCS T, R.EEGT. Coordinator NeuroDiag Ph: 416-6063 Pgr: 416-6661 Fax: 416-4373 -EKG/ECHO/Pulmonary -1 st Floor Regional Heart & Vascular Institute -Neurodiagnostics -Suite 306 3 rd Floor MOB Main Hospital Entrance Services offered in the Noninvasive Cardiopulmonary and Neurodiagnostic Departments include but are not limited to: Echocardiograms, Transesophageal Echo, Venous and Arterial Dopplers, Cardiac Stress Testing, Cardioversion, Tilt Table Testing, Cardiac Event and Holter monitoring (O/P holters applied by outpatient laboratory services), Pulmonary Function Testing, EEG, EMG and NCV, VER, and BAER. (*1) Results: Test reports are automatically sent electronically or via fax to referring physician offices. PULMONARY FUNCTION TESTING Patient Prep: Bring current medication list Light breakfast/lunch, no caffeine or stimulants (No coffee, tea or cola on morning of test No smoking or bronchodilators 4 hours prior to test Wear comfortable clothing and shoes (two-piece clothing for stress or exercise tests) COMMON PULMONARY FUNCTION CPT CODES Procedure CPT Code(s) BRONCHIAL PROVOCATION METHACHOLINE CHALL 94070 CARDIOPULMONARY EXERCISE TEST (simple) w/ PFTS no MET Cart 94620 CARDIOPULMONARY EXERCISE TEST (complex) w/ PFTS & w/ MET Cart 94621 DIFFUSING CAPACITY 94720 LUNG VOLUMES 94240 PFT FULL STUDY - SPIR DLCO AND LUNGVOL 94060 / 94240 / 94720 PULMONARY FUNCTION TEST - SIMPLE SPIROMETRY 94010 SPIROMETRY - BEFORE & AFTER BRONCHODILATOR 94060 SHHP Section F-1 11.18.14

SHHP Section F-2 11.18.14

CARDIAC STRESS TESTING GXT Stress: Graded exercise test including EKG and blood pressure monitoring. Standard Treadmill Stress Test. Patient must be able to walk on treadmill for duration of exercise. Patient Prep: May have light breakfast or lunch 2 hours prior to test (juice, toast etc.), no caffeine or nicotine, wear comfortable two-piece clothing and shoes, bring list of current medications. Stress Echo: Exercise stress test with pre and post echocardiographic images. A stress echo can accurately visualize the motion of the heart s wall and pumping action when the heart is stressed. Important! Order must indicate mode of stress. Treadmill (walking) vs. Dobutamine (pharmacological agent for those that can t adequately walk on the treadmill). Patient Prep: May have a light meal 2 hours prior if it is a treadmill test. Nothing to eat or drink 6 hours prior / nothing after midnight if test is early in morning for a dobutamine study. No caffeine or nicotine, wear comfortable two-piece clothing and shoes, bring list of current medications. Nuclear Stress Test (GXT with Radiopharmaceutical, Cardiolite Stress, Sestamibi Stress Test): Exercise stress test with rest and stress cardiac nuclear imaging. This test helps indicate areas of heart muscle damage present before and after exercise. Important! Order must indicate mode of stress. Treadmill (walking), Lexiscan or Dobutamine Dobutamine and Lexiscan are pharmaceuticals that are given to make the heart respond as if the patient is exercising (for those that can t walk adequately on the treadmill). Patient Prep: Nothing to eat or drink 4 hours prior to test (6 hours if lexiscan or dobutamine) / nothing after midnight if test is early in the morning, no nicotine, no caffeine (decaf still has caffeine in it) for 12 hours prior to test, comfortable two-piece clothing and shoes, bring current list of medications. PLEASE NOTE: 1) If requesting Dobutamine stress test, ordering physician must have patient hold Beta Blockers prior to test if considered safe. For all other stress tests consider having patient hold Beta Blockers to improve sensitivity of stress testing. 2) A diagnosis of chest pain alone does not typically meet the requirements of medical necessity for stress echo or nuclear stress testing. Please provide any additional pertinent diagnostic information on order request to validate necessity. COMMON CPT CODES Procedure CPT Code(s) NUCLEAR GXT - TREADMILL 93017 / 78452 NUCLEAR GXT - DOBUTAMINE 93017 / 78452 NUCLEAR GXT - LEXISCAN 93017 / 78452 CARDIOVERSON 92960 STRESS ECHO WITH EKG MONITORING 93351 DOBUTAMINE STRESS ECHO WITH EKG MONITORING 93351 SIGNAL AVERAGE EKG 93278 CARDIAC EVENT MONITOR 93270 / 93271 GRADED EXERCISE TEST TREADMILL 93017 TILT TABLE TEST 93660 SHHP Section F-3 11.18.14

CARDIOVASCULAR ULTRASOUND DEPARTMENT 1. Echocardiograms: (These are scheduled exams) Note: Pediatric exams for ages 0-10 are performed at Nemours. An ultrasound of the heart to evaluate overall wall motion, valves and any congenital defects. 2. Arterial Doppler or Arterial Duplex: (These are scheduled exams) For circulation issues Arterial Duplex is an ultrasound evaluation of either the upper or lower extremity arteries, which ever is specified by ordering physician. Arterial Doppler is a physiologic exam of either upper or lower extremity arteries, which ever is specified by ordering physician. A complete Arterial Doppler study will include Doppler waveforms and segmental pressures. A lower extremity Arterial Doppler study can be performed with or without exercise, which ever is specified by ordering physician. An ABI (Ankle/Brachial Index), is a limited lower extremity Arterial Doppler study Some common diagnosis: o Claudication o PVD 3. Venous Doppler: (We do these as a same day service if DVT study) Ultrasound to evaluate for blood clots/dvt (Deep Vein Thrombosis) Some common diagnosis: o Pain o Swelling 4. Venous Doppler for Reflux: (These are scheduled exams) Ultrasound to evaluate for venous insufficiency of the superficial veins of the legs. Some common diagnosis: o Varicose Veins o Venous Insufficiency NOTE: (For Medicare Patients only) Venous and Arterial studies cannot be performed on the same day on the same patient. When both studies are ordered, the venous study is done first, and then the arterial study is scheduled for a later date. COMMON CPT CODES Procedure CPT Code(s) ADULT 2D ECHO COMPL W/ SPECTRAL & COLOR DOPPLER 93306 ADULT 2D ECHO COMPL W/O SPECTRAL & COLOR DOPPLER 93307 ADULT 2D ECHO LIMITED OR FOLLOW UP 93308 ADULT COLOR DOPPLER-ADD ON 93325 ADULT SPECTRAL DOPPLER-ADD ON 93320 ADULT SPECTRAL DOPPLER LIMITED-ADD ON 93321 ADULT TRANSESOPHAGEALECHOCARDIOGRAM (TEE) 93312 / 93320 / 93325 ABI-ANKLE BRACHIAL INDICES 93922 ARTERIAL DOPPLER 93923 ARTERIAL DOPPLER WITH EXERCISE 93924 ARTERIAL DUPLEX IMAGING LOWER EXTREMITY 93925 / 93926 ARTERIAL DUPLEX IMAGING UPPER EXTREMITY 93930 / 93931 PEDIATRIC 2D ECHO COMP W/ SPECTRAL & COLOR DOPPLER 93306 / 93320 / 93325 PEDIATRIC 2D ECHO LIMITED OR FOLLOW UP W/LIMITED 93308 / 93325 / 93321 SHHP Section F-4 11.18.14

SPECTRAL & COLOR DOPPLER PEDIATRIC TRANSESOPHAGEALECHOCARDIOGRAM (TEE) 93315 / 93320 / 93325 SAPHENOUS VEIN MAPPING 93970 / 93971 VENOUS DOPPLER IMAGING UPPER OR LOWER EXTREMITY 93970 / 93971 SHHP Section F-5 11.18.14

NEURODIAGNOSTIC SERVICES EMG/NCV (Electromyography/NerveConduction Velocities) Scheduled exam (850-416-6800) Procedure is designed to test for neuromuscular disorders, entrapment neuropathies associated with traumatic and sports injuries. There is minimal discomfort associated with testing. Common Diagnoses: Carpal Tunnel Syndrome (CTS) Cervical Radiculopathy Lumbo-Sacral Radiculopathy Polyneuropathy Myopathy Brachial Plexopathy Patient Prep Skin should be free of lotions or oils. EEG (Electroencephalogram) Scheduled exam Testing is designed to test the electrical activity of the brain. Adults/Pediatrics Common Diagnoses: Seizures Stroke Headache/Migraines Patient Prep o Hair should be clean and free of hair products, oils, braids, weaves, pony tails, and barrettes. o Sleep deprivation is necessary. Ex. Go to bed two hours later than normal the night before the testing and wake 2 hours earlier than normal. o Do not drink caffeine or take stimulants prior to testing. (Please bring bottle or pacifier for young children). Patient Prep o Long Term Video EEG monitoring (Long Term Epilepsy Monitoring) Adults/Pediatrics For more information, please call 850-416-6800 BAER ( Brainstem Auditory Evoked Response) scheduled exams Testing is designed to check the auditory nerve pathway to the brainstem Adults/Pediatrics over 10 years of age Hair should be clean and free from hair products, braids, weaves, pony tails, and barrettes. Do not wear ear rings. VER (Visual Evoked Response) scheduled exams Testing is designed to check the visual nerve pathway to the brainstem Adults/Pediatrics over 10 years of age SHHP Section F-7 11.18.14

Patient Prep o Hair should be clean and free of hair products, oils, braids, weaves, pony tails, and barrettes.. *Patients should check in at the Main Entrance Admitting Office next door to elevator A. COMMON CPT CODES Procedure CPT Code(s) BAER (Brainstem Auditory Evoked Response) 95985 EEG (Electroencephalogram) 95819 EMG / NCS (Electromyogram /Nerve Conduction Study) 95886 / 95900 / 95903 / 95904 VER (Visual Evoked Response) 95930 SHHP Section F-8 11.18.14