General Surgery Housestaff
Trauma/SCC Coding Information
Major Organ Trauma, No Operation Required (MOTNOR)
- Graduates must have a minimum of 30 trauma cases for graduation.
- Of the 30 required cases, 10 will be the minimum number of operative trauma cases; 20 will be the minimum number of non-operative cases.
- The CPT code for recording nonoperative trauma is 99199.
- The category, major organ trauma, no operation required, is defined as patients with major organ trauma who were admitted to a specialty care unit in the hospital, ie, SICU, CCU, Burn Unit, etc.
- The most senior resident on the trauma service should claim credit for the MOTNOR case. In the instance where there is no trauma service, a fourth or fifth year general surgery resident may claim credit.
- If the patient subsequently requires a general surgery operative procedure that may be claimed in the defined category.
- The Critical Care Index Cases (CCIC) log was developed to provide documentation of resident management of a broad scope of critical care patients as follows:
- Each resident will develop a log of at least twenty critical care patients who represent the broad scope of critical care index management. (NB: do not submit 20 of the same conditions) CPT code 99292 will map to all seven of the surgical critical care conditions listed below.
- Each of the patients listed in the log should include the management of at least 2 of the 7 categories listed in #4 below.
- The completed logs should include experience, with at least one patient in all seven of the categories.
The categories are:
- 8410 - Ventilatory Management (>24 hours on a ventilator)
- 8420 - Bleeding (a non trauma patient requiring more than 3 units of blood/products and monitoring in ICU settings)
- 8430 - Hemodynamic Instability (requiring inotropic/pressor support)
- 8440 - Organ Dysfunction/Failure (etiology/mode of management, i.e. renal, hepatic, cardiac failure)
- 8450 - Dysrhythmias (requiring drug management)
- 8460 - Invasive Line Management and Monitoring (Swan-Ganz, A-lines, etc)
- 8470 - Parenteral/Enteral Nutrition
The residents are to maintain their own logs on the ACGME Web site.
The program director must sign off on the completed