Name	Value
NAME	GASTROINTESTINAL ENDOSCOPY
ORDERABLE ITEM	GASTROINTESTINAL ENDOSCOPY
NATIONAL STANDARD	1
ORDER PROMPTS	ORDER PROMPT: URGENCY REQUIRED: TRUE ORDER PROMPT: COLLECTION DATE/TIME REQUIRED: TRUE ORDER PROMPT: COLLECTION TYPE HIDE: TRUE DEFAULT: WC ORDER PROMPT: HOW OFTEN HIDE: TRUE ORDER PROMPT: SURGEON/PROVIDER REQUIRED: TRUE
PAGES	PAGE#: 1 PAGE NAME: Clinical History REQUIRED: TRUE RESPONSE ID: CLINHX WP TITLE: Additional Clinical History BUILDER BLOCK: PG BLOCK TITLE: Indication (check all that apply) LIST: TRUE VALUES: VALUE: Barrett's Esophagus VALUE: Candida VALUE: Colitis VALUE: H. Pylori VALUE: Malignancy VALUE: Microscopic Colitis VALUE: Sprue PAGE#: 2 PAGE NAME: Pre-Operative Diagnosis HIDE: TRUE RESPONSE ID: PREOPDX PAGE#: 3 PAGE NAME: Operative Findings RESPONSE ID: OPFIND PAGE#: 4 PAGE NAME: Post-Operative Findings HIDE: TRUE RESPONSE ID: POSTOPDX
SPECIMEN	BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN BUILDER BLOCK: SP BLOCK TITLE: Technique VALUES: Biopsy Brushing EMR FNA Hot Biopsy Hot Snare SP BLOCK TITLE: Specimen Type VALUES: Erosion Lesion Mass Polyp Random Ulcer COLLECTION SAMPLE HIDE: TRUE COLLECTION SAMPLE DEFAULT: AP SPECIMEN

GASTROINTESTINAL ENDOSCOPY (1693) AP DIALOG CONFIG (101.45)