RENAL BIOPSY (1696)    AP DIALOG CONFIG (101.45)

Name Value
NAME RENAL BIOPSY
ORDERABLE ITEM RENAL BIOPSY
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:   Imaging Technique
      VALUES:
      • VALUE:   Ultrasound
      • VALUE:   CT Scan
    • PG BLOCK TITLE:   Indication for Biopsy
      LIST:   TRUE
      VALUES:
      • VALUE:   Proteinuria
      • VALUE:   Hematuria
      • VALUE:   Acute kidney injury
      • VALUE:   Chronic kidney disease
      • VALUE:   Renal mass
    • PG BLOCK TITLE:   Request Type
      REQUIRED:   TRUE
      VALUES:
      • VALUE:   Neoplastic
      • VALUE:   Medical
  • PAGE#:   2
    PAGE NAME:   Pre-Operative Diagnosis
    REQUIRED:   TRUE
    RESPONSE ID:   PREOPDX
  • PAGE#:   3
    PAGE NAME:   Operative Findings
    RESPONSE ID:   OPFIND
  • PAGE#:   4
    PAGE NAME:   Post-Operative Findings
    RESPONSE ID:   POSTOPDX
SPECIMEN
  • BUILDER BLOCK:
    • SP BLOCK TITLE:   Specimen Type
      VALUES:
      • Percutaneous Core Biopsy
      • Open Wedge Biopsy
      • IR Core Biopsy
    • SP BLOCK TITLE:   Laterality
      VALUES:
      • Left
      • Right
    • SP BLOCK TITLE:   Submission Type
      VALUES:
      • Fresh
        SPECIAL:   OPURG;1
      • Fixed
      • Intra-Op Consult
        SPECIAL:   OPURG;1
    COLLECTION SAMPLE HIDE:   TRUE
    COLLECTION SAMPLE DEFAULT:   AP SPECIMEN
PROMPT CHANGE MESSAGE was changed from to . $C(13,10)If you do not desire this change, please change the prompt at the top of the form.