Qtr 1 Physician RBM 2017 (Med/Surg) case study # 3
CIGNA SI-PPO/OAP Commercial
77059- MRI breast bilateral, without and/or with contrast material(s)
51 y/o F
Case initiated 2/1/2017
To MD Review/ Per ACDS notes /Fax/Web notes
LOV: 1/13/17
Reason: High risk for breast cancer screening
ONC Member Hx: Updated
Prior Imaging: 12/2/16- Mammo- BIRADS 1
PE: No abnormal PE findings
Sx: fatigue
Labs: Chek 2 mutation associated with increased risk of breast ca, 30%. LFTs and tumor markers not provided
NURSE COMMENT: Imaging may not be indicated. (C-CH-25.6)
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