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Resident Letter
Dear Urology resident or fellow: While many of you are already actively documenting your operative experiences in the ACGME on-line system, this mailing is intended to answer some frequently asked questions about the on-line USOL (urologic surgery operative log) and to facilitate the entry of data into this system. Why is the ACGME switching to the on-line USOL? The goal is to create a real-time, on-going listing of residents' operative experiences so that their surgical training can be easily monitored and optimized. This new on-line system replaces a floppy-disk spreadsheet system which only gave a single snap-shot of a resident's surgical experience at the end of his/her training. By when must I have back-loaded my operative data into the on-line USOL? All chief residents must have all of their operative data from their urology years up-to-date on the on-line system by July 1, 2001. All other residents are strongly encouraged to have their USOL operative data up-to-date shortly thereafter. Should I enter the cases from my general surgery years? No. The ACGME is only interested in all the urologic procedures you performed during your urology years. What are index cases? The residency review committee (RRC) for urology has defined a list of procedures which it feels are crucial for the training of a urologist. The numbers and distribution of these index cases are used by the RRC in determining the accreditation status of a residency. The following is the current list of the categories of index cases for urology: Adult Index Procedures:
Pediatric Index Procedures:
Can I load my previous cases in bulk? Your program director can decide whether to allow you to enter your previous cases in bulk for a given year of your training. The program director should add 'not applicable' to the on-line list of attendings and institutions so that bulk data can be entered under these headings. While no patient identification numbers need to be cited, the data must be entered under a date (any date) in the academic year in which they were performed. After completing these fields on the procedure entry screen, just select the appropriate CPT codes. For instance, to bulk load 20 radical prostatectomies, enter the CPT code for radical prostatectomy 20 times in a given entry. The copy-and-paste functions on your computer (right mouse button) should speed this up even further. What should I do if an institution or attending urologist is not listed on the on-line USOL? Please contact your program director so that these listings can be updated and/or expanded. What are CPT codes? CPT (current procedural terminology) is the official coding system of the AMA (American Medical Association) and is used by HCFA (Health Care Financing Administration) for physician services under the Medicare program. These codes are updated yearly and form the basis for entering operative data into the on-line USOL. What should I do if a procedure is not listed on the on-line USOL? If the procedure is not listed in the urology index categories, then the procedure is not considered an index procedure by the RRC and will not play a role in their accreditation decisions.
How do I enter data for an operation that was performed bilaterally? If a given operation does not have separate CPT codes for the unilateral vs. bilateral procedure, please enter the same CPT code twice to indicate a bilateral procedure. What should I do if I make a mistake while entering data? Use the Search/Update function in the Procedure Menu to identify a given entry, and then use the Edit function under that entry to make the necessary changes. Must I have the patient ID number for each case that I performed? No. The patient ID number is an optional field in the procedure entry screen included to assist program directors in verifying the authenticity of operative data. The required fields for each entry are resident, attending, institution, resident year, resident role, procedure date, and CPT code. How are the roles of surgeon versus assistant defined? To be recorded as the surgeon, a resident must be present for the entirety of the case and must perform a major portion of the procedure. The ACGME suggests that this determination should be confirmed by the resident's supervisor. All other participation should be classified as 'assistant'. Can I obtain credit as surgeon for more than one operation when performing surgery on a single patient? In most cases, the answer is no. For instance, a resident who performs a radical nephrectomy cannot take credit for a nephrectomy, adrenalectomy, and retroperitoneal lymphadenectomy. However, there are some multi-component operations that incorporate individual procedures that are commonly performed as individual operations, i.e. pelvic lymphadenectomy. Thus, in these certain approved cases, credit for more than one procedure can be obtained. The approved exceptions: ·
Can two residents obtain credit as surgeon during one operation? Yes, in certain circumstances. · When one resident is performing a radical prostatectomy, he can permit another resident to make the incision and perform the pelvic lymphadenectomy before performing the radical prostatectomy. In this case, one resident is the assistant on the lymphadenectomy and the surgeon on the prostatectomy, and the other resident is the surgeon on the lymphadenectomy and the assistant on the prostatectomy. · In cases where a bilateral operation or multiple operations are performed, two residents can each obtain credit for a unilateral or single procedure. Can I find out the average number of index cases performed by graduating urology residents across the country in order to ensure that my training is not deficient in a given area? Your program director should have access to this data. Please discuss with him or her how best to obtain this information. How can I speed up the entry of operative data? Use a computer with a fast internet connection to speed up data entry and searches for CPT codes. Print out the list of the index CPT codes from the ACGME web-site to save time searching for the appropriate CPT codes. Enclosed is a partial listing of common CPT codes to facilitate the entry of operative data. How can I get more information about the on-line USOL? A useful Data Entry Manual and the entire listing of index procedures for urology can be downloaded from the ACGME site. Please contact the ACGME Help Desk (312-755-7464) for further information. While the entry of data into the on-line USOL takes some time, it is designed to be less time-intensive than the previous floppy-disk system. It should also greatly assist the ACGME in optimizing the training of Urology residents and fellows in the near future. Thank you for your participation in this undertaking. Sincerely, B. Price Kerfoot, M.D., Ed. M. Resident member, Residency Review Committee for Urology |
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List of all common cpt codes for Adult and Pediatric Index Procedures |
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