3rd Qtr Physician 2016 Med Surg Case Study #2

28yoM AETTX FI-PPO

Provider Specialty: Reproductive Endocrinology

Request Initiated: 5/6/16

CPT: 72197 MRI PELVIS; without contrast material(s), followed by contrast material(s) and further sequences

ICD-10: N80.0 Endometriosis of uterus

Nurse Reviewer Note:

Christina/MDO/Reproductive ENDO Req: MRI pelvis w/wo
For: 28 yo F C/O: Stomach cramping

Reason: R/O: Adenomyosis

FOV: 2011 LOV: 4/29/16

PE: Pelvic Exam: Normal

PMH: Infertility, Miscarriage x 1, irregular menses, no personal hx of Ca:

TX: 3 IUI failed cycles, 2 Failed IVF cycles last one being 3/1/16-4/29/16 Failed Fertility TX

Labs: no relevant labs

Prior Imaging: 4/11/16 TV US: for retrieval of eggs-only(not a full US)

ACDS Note Reviewed

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