| 1 | English French Notes Complete/Exclude
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| 2 | functional impairments.
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| 3 | 1. Shape and dimension (specify units) -
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| 4 | 4. Provide photographs for all facial burns and any
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| 5 | areas of especially repugnant disfigurement -
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| 6 | 5. Tender and painful on objective demonstration -
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| 7 | STOMACH (DIGESTIVE)
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| 8 | The term
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| 9 | should not be used in examination
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| 10 | reports. Ulcer site should be localized as
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| 11 | so as to conform to rating
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| 12 | schedule terminology.
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| 13 | 4. Periodic vomiting -
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| 14 | 5. Recurrent hematemesis or melena -
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| 15 | 6. Area of pain -
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| 16 | 7. Number of days of duration per episode -
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| 17 | 8. Frequency of episodes per year -
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| 18 | SYSTEMIC CONDITIONS
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| 19 | Many systemic conditions have stormy acute phases during
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| 20 | onset and recurrences but leave little or no residual
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| 21 | disability after they are cured or arrested. Others have slow
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| 22 | progression with disabling
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| 23 | residuals, after relatively mild
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| 24 | or transient earlier phases. The examiner must search for and
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| 25 | describe the residual disabilities upon which adjudication
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| 26 | of the claim can be determined.
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| 27 | 1. Renal impairment -
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| 28 | 2. Mental changes -
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| 29 | Diagnosis (if malaria, tuberculosis, or other mycobacterial
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| 30 | disease, specify organism):
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| 31 | 1,5,0,2:2,0^AMIE Exam spelling correction
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| 32 | PYELITIS, NEPHROLITHIAIS, ETC.
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| 33 | 0,7,0,1:2,0^It is now spelled 'PYELITIS, NEPHROLITHIASIS, ETC.'
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| 34 | 0,5,0,2,0^'PYELITIS, NEPHROLITHIAIS, ETC.' NOT corrected.
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| 35 | 0,7,0,1:2,0^Check this exam in the AMIE EXAM FILE (396.6)
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| 36 | -1^Global root not defined or is null
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| 37 | -2^Sending package name not defined or is null
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| 38 | -3^Soft link not defined or is null
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| 39 | -3^Date of exam not defined.
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| 40 | -3^Physician is not defined.
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| 41 | -9^Check New Person file pointer value.
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| 42 | -10^Check exam date.
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| 43 | -1^File number of soft link is bad
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| 44 | -1.5^File number of soft link is incorrect.
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| 45 | -2^Entry number in soft link is bad
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| 46 | -3^Second file number in soft link is bad
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| 47 | -3.5^Second file number in soft link is incorrect.
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| 48 | -4^2507 Exam entry number in soft link is bad
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| 49 | -5^This request nolonger exists
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| 50 | -6^This request is nolonger open
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| 51 | -7^Exam nolonger exists.
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| 52 | -8^Exam can nolonger accept data
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| 53 | -9^This exam does not belong to the proper request.
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| 54 | -1^Patient's DFN not defined OR is null
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| 55 | -2^Exam not defined OR is null
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| 56 | -3^No 2507 request for this patient
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| 57 | -8^More than one open exam
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| 58 | -4^No Exam by that name in the 2507 Exam file
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| 59 | -6^No open Exam for data given
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| 60 | -7^Exam cross reference is bad
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| 61 | -5^No open requests for data given
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| 62 | ;^Soft Link entry
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| 63 | SENSE OF TASTE
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| 64 | The recommended test substances are sugar, diluted acetic
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| 65 | acid, quinine, and common salt. If electrogustrometry
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| 66 | is available, it should be used as the preferred test for
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| 67 | this exam. Report whether loss is partial or complete
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| 68 | and whether it is on an organic basis. If a psychiatric
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| 69 | Substances used for testing and results:
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| 70 | TESTIS, TRAUMA, OR DISEASE (GU)
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| 71 | Loss of use of a testis when based upon its small size or soft
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| 72 | consistency must be described by a board of at least three
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| 73 | physicians including at least one urologist. The board of
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| 74 | physicians should review the physician's guide for special
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| 75 | 1. Atrophy or absence of one or both testis -
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| 76 | BAD Hospital Location record - Contact IRM
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| 77 | AMIE appointment integrity report
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| 78 | Appt Date
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| 79 | Date Appt Made
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| 80 | Clerk
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| 81 | 0,0,0,2,0^Enter the following information for the
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| 82 | 0,0,0,1:1,0^ exam being returned as insufficient.
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| 83 | ORIGINAL PROVIDER:
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| 84 | Enter the Original Provider who performed the examination,
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| 85 | if the exam was performed on the original 2507 request.
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| 86 | Include the facility name if the exam was performed at another site.
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| 87 | Report Type
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| 88 | Examination Appointment Links
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| 89 | Which Current Appt is
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| 90 | a reschedule of?
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| 91 | Initial Appt
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| 92 | Clock Stop Appt
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| 93 | Current Appt
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| 94 | DVBC LINK
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| 95 | ENTER '^' TO STOP OR
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| 96 | Select a link by entering its associated number.
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| 97 | 'Initial Appt' is the first appointment made to complete the exam.
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| 98 | 'Clock Stop Appt' is the date the processing clock will be stopped for the
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| 99 | series of linked appointments, if the veteran reschedules or no shows.
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| 100 | 'Current Appt' is the appointment the link shows as currently scheduled
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|---|
| 101 | to complete the examination.
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| 102 | Select from the numbers listed.
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| 103 | 1,3,0,2:1,0^All exams must be reviewed....Insufficient link and info not updated!
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| 104 | 1,3,0,2:1,0^Review exam info for a new Original Provider.
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| 105 | Do you want to edit the insufficient information for the exams
|
|---|
| 106 | Enter Yes to edit Remarks, Insufficient Reason and Original Providor (when
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|---|
| 107 | appropriate). Enter No to keep the current information.
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|---|
| 108 | INSUFFICIENT REASON:
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| 109 | 0,0,0,0,0^NOT ALLOWED
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|---|
| 110 | 0,5,0,1,0^Enter the insufficient reason this exam is being returned.
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|---|
| 111 | 0,1,0,1,0^ANSWER WITH 2507 INSUFFICIENT REASONS INSUFFICIENT CODE
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|---|
| 112 | Enter the insufficient reason this exam is being returned.
|
|---|
| 113 | ANSWER WITH 2507 INSUFFICIENT REASONS INSUFFICIENT CODE
|
|---|
| 114 | DO YOU WANT THE ENTIRE 13-ENTRY 2507 INSUFFICIENT REASONS LIST?
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|---|
| 115 | 0,0,0,1,0^This field contains a pointer to the Insufficient Reason file (396.94).
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| 116 | 0,0,0,2,0^CHOOSE FROM:
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| 117 | 0,0,0,1,0^There are no links to this 2507 request.
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|---|
| 118 | Current Appointment Links
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|---|
| 119 | Enter [Return] to continue or
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|---|
| 120 | to exit
|
|---|
| 121 | Select an appointment to link to the 2507 request
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|---|
| 122 | Display Current C&P Appointment Links
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| 123 | Canceled by MAS
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| 124 | Canceled by RO
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| 125 | Transferred Out
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| 126 | Terminal
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| 127 | Prisoner of war
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|---|
| 128 | Original SC
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|---|
| 129 | Original NSC
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|---|
| 130 | Increase
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|---|
| 131 | Review
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|---|
| 132 | Inadequate exam
|
|---|
| 133 | No Zip
|
|---|
| 134 | Exams on this request:
|
|---|
| 135 | Period of service:
|
|---|
| 136 | Pend ver
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|---|
| 137 | Pend re-verif
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|---|
| 138 | Not verified
|
|---|
| 139 | 0,3,0,2,0^Insufficient Reason:
|
|---|
| 140 | 0,3,0,2:1,0^Insufficient Remarks:
|
|---|
| 141 | Insufficient remarks, continued
|
|---|
| 142 | Press RETURN to continue...
|
|---|
| 143 | This exam has been cancelled by the RO.
|
|---|
| 144 | This exam has been completed.
|
|---|
| 145 | This exam has been cancelled by MAS.
|
|---|
| 146 | This exam has been released to the RO.
|
|---|
| 147 | Is transcription completed for this exam
|
|---|
| 148 | Enter Y if all information has been entered and transcription is finished
|
|---|
| 149 | or N if more information will be entered later
|
|---|
| 150 | Select exam:
|
|---|
| 151 | Enter Yes to access the Physician's Guide using Text Retreival.
|
|---|
| 152 | Enter the ending date:
|
|---|
| 153 | 1,0,0,2:2,0^Beginning date must be before ending date!
|
|---|
| 154 | Select a 2507 request
|
|---|
| 155 | Request date:
|
|---|
| 156 | ENTER '^' TO STOP, OR
|
|---|
| 157 | Select a 2507 request by entering it's associated number
|
|---|
| 158 | Select C&P Veteran Name:
|
|---|
| 159 | This is required to continue processing with the AMIE link management option.
|
|---|
| 160 | Current appointment links
|
|---|
| 161 | AMIE exams on 2507 request for:
|
|---|
| 162 | 2507 Request Date Reported to MAS:
|
|---|
| 163 | Exam:
|
|---|
| 164 | Select an appointment by entering its associated number.
|
|---|
| 165 | *CL following Clinic means the appointment date is the
|
|---|
| 166 | Current Date for
|
|---|
| 167 | an existing link.
|
|---|
| 168 | Enter '1' to see the current links to this 2507.
|
|---|
| 169 | Initial Appt:
|
|---|
| 170 | Clock Stop Appt:
|
|---|
| 171 | Last Veteran requested Appointment:
|
|---|
| 172 | Current Appt:
|
|---|
| 173 | INITIAL APPT DATE
|
|---|
| 174 | ORIGINAL APPT DATE
|
|---|
| 175 | APPOINTMENT STATUS
|
|---|
| 176 | CURRENT APPT DATE
|
|---|
| 177 | The C&P appointment link was not properly added. Please investigate the
|
|---|
| 178 | appointment scheduled for
|
|---|
| 179 | Up+
|
|---|
| 180 | Up
|
|---|
| 181 | Up nasal
|
|---|
| 182 | Nasal+
|
|---|
| 183 | Nasal
|
|---|
| 184 | Down nasal
|
|---|
| 185 | B. Visual Acuity:
|
|---|
| 186 | Near
|
|---|
| 187 | Far
|
|---|
| 188 | Right Eye
|
|---|
| 189 | Uncorrected
|
|---|
| 190 | Corrected
|
|---|
| 191 | Left Eye
|
|---|
| 192 | F. Diagnostic/clinical test results (other than visual acuity,visual fields
|
|---|
| 193 | or diplopia):
|
|---|
| 194 | Attachment - Visual Exam
|
|---|
| 195 | DVBC,
|
|---|
| 196 | *** The function keys F9 for 'Print List' and F12 for 'Super Quit' ***
|
|---|
| 197 | *** are available. ***
|
|---|
| 198 | For ACROMEGALY
|
|---|
| 199 | For AID AND ATTENDANCE OR HOUSEBOUND EXAMINATION
|
|---|
| 200 | For ARRHYTHMIAS
|
|---|
| 201 | For AMPUTATION, RESIDUALS OF
|
|---|
| 202 | Date of Exam: ____________________
|
|---|
| 203 | Place of Exam: ___________________
|
|---|
| 204 | For ARTERIES AND VEINS
|
|---|
| 205 | For BONES (Fractures and Bone Disease)
|
|---|
| 206 | For BRAIN AND SPINAL CORD
|
|---|
| 207 | For COLD INJURY PROTOCOL EXAMINATION
|
|---|
| 208 | For CRANIAL NERVES
|
|---|
| 209 | For CUSHING'S SYNDROME
|
|---|
| 210 | For DIABETES MELLITUS
|
|---|
| 211 | For DIGESTIVE CONDITIONS, MISCELLANEOUS
|
|---|
| 212 | (Tuberculous Peritonitis, Inguinal Hernia, Ventral Hernia,
|
|---|
| 213 | Femoral Hernia, Visceroptosis, and Benigh and Malignant
|
|---|
| 214 | New Growths)
|
|---|
| 215 | For DENTAL AND ORAL
|
|---|
| 216 | For EATING DISORDERS (Mental Disorders)
|
|---|
| 217 | ...is it at least as likely as not...
|
|---|
| 218 | EATING DISORDERS (Mental Disorders)
|
|---|
| 219 | For EAR DISEASE
|
|---|
| 220 | For EYE EXAMINATION
|
|---|
| 221 | For ESOPHAGUS AND HIATAL HERNIA
|
|---|
| 222 | For ENDOCRINE DISEASES, MISCELLANEOUS
|
|---|
| 223 | (Benign and Malignant Neoplasms, Hyperpituitarism,
|
|---|
| 224 | Hyperaldosteronism, and Pheochromocytoma)
|
|---|
| 225 | For EPILEPSY AND NARCOLESPY
|
|---|
| 226 | For EPILEPSY AND NARCOLEPSY
|
|---|
| 227 | For FIBROMYALGIA
|
|---|
| 228 | For CHRONIC FATIGUE SYNDROME
|
|---|
| 229 | For FEET
|
|---|
| 230 | For GENITOURINARY EXAMINATION
|
|---|
| 231 | For GENERAL MEDICAL EXAMINATION
|
|---|
| 232 | GULF WAR GUIDELINES
|
|---|
| 233 | Handout of Instructions for Compensation and
|
|---|
| 234 | but will also need to request more laboratory
|
|---|
| 235 | For GYNECOLOGICAL CONDITIONS AND DISORDERS OF THE BREAST
|
|---|
| 236 | For HEMIC DISORDERS
|
|---|
| 237 | For HEART
|
|---|
| 238 | For HEART
|
|---|
| 239 | For HEART AND HYPERTENSION
|
|---|
| 240 | For HIV-RELATED ILLNESS
|
|---|
| 241 | For HAND, THUMB AND FINGERS
|
|---|
| 242 | For HAND, THUMB, AND FINGERS
|
|---|
| 243 | position of function
|
|---|
| 244 | For HYPERTENSION
|
|---|
| 245 | For INTESTINES (LARGE AND SMALL)
|
|---|
| 246 | For JOINTS (SHOULDER/ELBOW/WRIST/HIP/KNEE/ANKLE)
|
|---|
| 247 | LIVER, GALL BLADDER, AND PANCREAS
|
|---|
| 248 | consistent with
|
|---|
| 249 | LIVER, GALL BLADDER AND PANCREAS
|
|---|
| 250 | For LIVER, GALL BLADDER AND PANCREAS
|
|---|
| 251 | For LIVER, GALL BLADDER, AND PANCREAS
|
|---|
| 252 | For LYMPHATIC DISORDERS
|
|---|
| 253 | For MENTAL DISORDERS (except PTSD and Eating Disorders)
|
|---|
| 254 | ...is it at least as
|
|---|
| 255 | , fully explain the clinical findings and
|
|---|
| 256 | MENTAL DISORDERS (except PTSD and Eating Disorders)
|
|---|
| 257 | # XXXX Worksheet
|
|---|
| 258 | ...is it
|
|---|
| 259 | , fully explain the clinical findings
|
|---|
| 260 | For MOUTH, LIPS, AND TONGUE
|
|---|
| 261 | For MENTAL DISORDERS (not initial PTSD and eating disorders)
|
|---|
| 262 | For MUSCLES
|
|---|
| 263 | For NEUROLOGICAL DISORDERS, MISCELLANEOUS
|
|---|
| 264 | For SPINE (Cervical, Thoracic and Lumbar)
|
|---|
| 265 | SPINE (Cervical, Thoracic and Lumbar)
|
|---|
| 266 | For NOSE, SINUS, LARYNX, AND PHARYNX
|
|---|
| 267 | For PRISONER OF WAR PROTOCOL EXAMINATION
|
|---|
| 268 | INITIAL EVALUATION FOR POST-TRAUMATIC STRESS DISORDER (PTSD)
|
|---|
| 269 | cutting scores
|
|---|
| 270 | ... is it at least as likely
|
|---|
| 271 | , fully explain the clinical findings and rationale for the opinion.
|
|---|
| 272 | REVIEW EXAMINATION FOR POST-TRAUMATIC STRESS DISORDER (PTSD)
|
|---|
| 273 | For PERIPHERAL NERVES
|
|---|
| 274 | For POST-TRAUMATIC STRESS DISORDER (PTSD)
|
|---|
| 275 | ... is it at least as likely as not ...
|
|---|
| 276 | For PULMONARY TUBERCULOSIS AND MYCOBACTERIAL DISEASES
|
|---|
| 277 | For RECTUM AND ANUS
|
|---|
| 278 | For RESPIRATORY DISEASES, MISCELLANEOUS
|
|---|
| 279 | (PVD, Neoplasms, Bacterial Infections,
|
|---|
| 280 | Mycotic Lung Disease, Sarcoidosis, and Sleep Apnea)
|
|---|
| 281 | RESPIRATORY (OBSTRUCTIVE, RESTRICTIVE, AND INTERSTITIAL)
|
|---|
| 282 | For RESPIRATORY (OBSTRUCTIVE, RESTRICTIVE, AND INTERSTITIAL)
|
|---|
| 283 | For INFECTIOUS, IMMUNE, AND NUTRITIONAL DISABILITIES
|
|---|
| 284 | For SKIN DISEASES (Other Than Scars)
|
|---|
| 285 | Scars
|
|---|
| 286 | RESPIRATORY DISEASES, MISCELLANEOUS
|
|---|
| 287 | For SENSE OF SMELL AND TASTE
|
|---|
| 288 | For STOMACH, DUODENUM AND PERITONEAL ADHESIONS
|
|---|
| 289 | For STOMACH, DUODENUM, AND PERITONEAL ADHESIONS
|
|---|
| 290 | For SCARS
|
|---|
| 291 | For THYROID AND PARATHYROID DISEASES
|
|---|
| 292 | For ARTERIES, VEINS AND MISCELLANEOUS
|
|---|
| 293 | For ARTERIES, VEINS AND MISCELLANEOUS
|
|---|
| 294 | is CANCELED and cannot be transferred.
|
|---|
| 295 | is COMPLETED and cannot be transferred.
|
|---|
| 296 | has been TRANSFERRED and cannot be selected.
|
|---|
| 297 | is OK to transfer.
|
|---|
| 298 | Transfer C&P Exams
|
|---|
| 299 | This request does not have a PENDING status and may not be transferred.
|
|---|
| 300 | This request was transferred in and CANNOT be transferred to any other site !
|
|---|
| 301 | Is this the correct request
|
|---|
| 302 | Enter Y if the correct Veteran or N if not.
|
|---|
| 303 | #################### #################### ####################
|
|---|
| 304 | #################### #################### ####################
|
|---|
| 305 | #################### #################### ####################
|
|---|
| 306 | #################### #################### ####################
|
|---|
| 307 | #################### #################### ####################
|
|---|
