©2011-2018 Open Source Electronic Health Record Alliance
This work is licensed under a Creative Commons Attribution 3.0 Unported License
This work is licensed under a Creative Commons Attribution 3.0 Unported License
DVBCWPM1 ;ALB/ESW PULMONARY TB AND MYCO. DIS. WKS TEXT - 1 ; 10 Oct 2000
;;2.7;AMIE;**34**;Apr 10, 1995
;
TXT ;
;;A. Review of Medical Records:
;;
;;B. Medical History (Subjective Complaints):
;; Comment on:
;;
;; 1. Activity of pulmonary tuberculosis or other mycobacterial disease.
;; 2. Date of inactivity if it is not active.
;; 3. Identity of organism (if possible).
;;
;;C. Physical examination (Objective Findings):
;; Address each of the following and fully describe current findings:
;;
;; 1. Extent of structural damage to lungs.
;; 2. If patient was hospitalized for 6 months or more, what is the
;; condition at the end of hospitalization?
;; 3. If patient was hospitalized for 12 months or more, what is the
;; condition at the end of hospitalization?
;;
;;D. Diagnostic and Clinical Tests:
;;Provide:
;;
;;1. Pulmonary Function Tests, if indicated. If performed, include the results
;; in the examination report, The FEV-1,FVC, and FEV-1/FVC should be included.
;; Both pre- and post-bronchodilatation pulmonary function test results should
;; be reported. If post-bronchodilatation test is not conducted in a particular
;; case, please provide an explanation of why not. A DLCO may or may not be
;; done routinely as part of pulmonary function testing at a particular
;; facility. If there is a disparity between the results of different tests,
;; please indicate which tests are more likely to accurately reflect
;; the severity of the condition.
;;
;; DLCO note: If DLCO was not done as a routine part of pulmonary function
;; testing, the examiner should use his or her judgment, based on
;; the specific condition (.e.g., whether it is obstructive,
;; interstitial, etc.) and other available information about the condition,
;; as to whether a DLCO test is needed, since it is not useful in all
;; situations. If it may provide useful information about the severity
;; of the condition, it should be requested and reviewed before
;; the examination report is submitted. If the examiner determines that
;; the DLCO test is not needed, a statement as to why not (e.g., there are
;; decreased lung volumes that would not yield valid test results) should be
;; included in the report. Such a statement could avoid a remand from BVA
;; when the test is not done. However in the case of a BVA remand in which
;; the DLCO is requested, the DLCO MUST be done unless there is a medical
;; contraindication.
;;
;;E. Diagnosis:
;;
;; 1. In reactivated cases, is this reactivation of the old disease
;; or a separate and distinct new infection?
;;
;;ADDITIONAL NOTE TO THE EXAMINER:
;;
;;In all claims, if the disease is inactive and if the inactivity was confirmed
;;at a non-VA facility, obtain the name and mailing address of the facility
;;from the veteran so that the Regional Office may request the report.
;;
;;
;;Signature: Date:
;;END