INSTRUCTIONS:
Cost Center: 813
For Santa Rosa location, see cost center 825.
Dictated Work Type: 9
Document Type: 11 Facility: 1
Five letterhead normal possibilities. .
1. For Liver Transplant, use CC813LT.
2. For Walnut Creek, use CC813WC.
3. For Dr. Heyman use CC813H
4. For Pleasanton, use CC813PL.
5. For everything else (non-transplant patients) use CC813.
For Liver Transplant, letterhead normal: CC813LT
DEPARTMENT OF PEDIATRICS
GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION
PEDIATRIC LIVER TRANSPLANT PROGRAM
500 Parnassus Avenue
MU-416 East, Box 0136
San Francisco, California 94143-0136
Tel: (415) 476-5892
Fax: (415) 476-1343
Physician Hotline: 800-UC KID GI (800-825-4344)
BILL AREA: PSG
For Walnut Creek location, letterhead normal: CC813WC
UCSF FACULTY PRACTICE AT WALNUT CREEK
PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION
2123 Ygnacio Valley Road, Suite K100
Walnut Creek, California 94598
Tel: (925) 280-8131
Fax: (925) 280-8130
After hours/weekends Tel: (415) 476-5892
BILL AREA: PSG
For Pleasanton location, letterhead normal: CC813PL
DIVISION OF PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION
UCSF FACULTY PRACTICE IN PLEASANTON
5565 West Las Positas Boulevard, Suite 320A
Pleasanton, CA 94588-4001
Tel: (925) 598-3500 Fax: (925) 598-3520
After hours/weekends Tel: (415)476-5892
BILL AREA: PSG
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INSTRUCTIONS: Cost Center 831 (continued):
For all others, letterhead normal: CC813
DEPARTMENT OF PEDIATRICS
GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION
500 Parnassus Avenue
MU-416 East, Box 0136
San Francisco, California 94143-0136
Tel: (415) 476-5892
Fax: (415) 476-1343
Physician Hotline: 800-UC KID GI (800-825-4344)
Five possible location subtitles; dictators will indicate where clinic took place:
PARNASSUS CLINIC
MODESTO CLINIC
MARIN CLINIC
CCS CLINIC
INFLAMMATORY BOWEL DISEASE CLINIC
BILL AREA: PSG
Providers:
NEERA GUPTA, M.D.
ASSISTANT PROFESSOR OF PEDIATRICS
DIVISION OF PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION
MELVIN B. HEYMAN, M.D.
see page 4 for instructions
HILARY A. PERR, M.D.
ASSOCIATE CLINICAL PROFESSOR OF PEDIATRICS
DIVISION OF PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION
JOHN D. SNYDER, M.D.
PROFESSOR OF PEDIATRICS
DIVISION OF PEDIATRIC GASTROENTEROLOGY,
HEPATOLOGY AND NUTRITION
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Confidential Property of Acusis
INSTRUCTIONS: Cost Center 813 (continued):
PHILIP ROSENTHAL, M.D.
PROFESSOR OF PEDIATRICS AND SURGERY
DIRECTOR OF PEDIATRIC HEPATOLOGY
MEDICAL DIRECTOR, PEDIATRIC LIVER TRANSPLANT SERVICE
DIVISION OF PEDIATRIC GASTROENTEROLOGY,
HEPATOLOGY AND NUTRITION
SUE JUNG RHEE, M.D.
ASSISTANT PROFESSOR OF PEDIATRICS
MEDICAL DIRECTOR, PEDIATRIC INTESTINAL REHABILITATION & TRANSPLANTATION
PROGRAM
DIVISION OF PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY, AND NUTRITION
WALTER E. SIPE, M.D.
CLINICAL INSTRUCTOR OF PEDIATRICS
PATRIKA TSAI, M.D., M.P.H.
ASSISTANT PROFESSOR OF PEDIATRICS
DIVISION OF PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION
Other providers/dictators:
BETSY HAAS-BECKERT, RN, MS, PNP
CLINICAL NURSE SPECIALIST
Will always be a signatory, either alone or
with an M.D. Add second signature block
of attending when she indicates; HaasBeckert should be listed first. Whether dictating as sole signatory or in conjunction with an
M.D., her name (not the M.D.'s) goes in both dictating and attending fields.
SUSAN STRITZEL-DIAZ, RN, MSN, PNP
PEDIATRIC LIVER TRANSPLANT SERVICE
Dictates for Rosenthal.
LAURA BRIDGERS, RN, MSN, CPNP
Dictates for Heyman.
INFLAMMATORY BOWEL DISEASE CLINICAL COORDINATOR
PEDIATRIC INFLAMMATORY BOWEL DISEASE PROGRAM
CHRISTINE MUDGE-GROUT, RN, MS, PNPc, CNN, FAAN
PEDIATRIC LIVER TRANSPLANT SERVICE
Dictates for Rosenthal and
possibly others. Can be
sole signatory; she will
specify. Also at cost
centers 632 and 614.
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Confidential Property of Acusis
INSTRUCTIONS: Cost Center 813 (continued):
NICOLE HODGEBOOM, RN, MS, CPNP
CLINICAL NURSE SPECIALIST
PEDIATRIC LIVER TRANSPLANT SERVICE
Can be sole signatory;
she will specify. May in
future be at cost centers
2 and 614 also.
Letterhead normal for Dr. Heyman – CC813H
DEPARTMENT OF PEDIATRICS
GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION
UCSF PEDIATRIC INFLAMMATORY BOWEL DISEASE PROGRAM
500 Parnassus Avenue
MU-416 East, Box 0136
San Francisco, California 94143-0136
Tel: (415) 476-5892
Fax: (415) 476-1343
Physician Hotline: 800-UC KID GI (800-825-4344)
BILL AREA: PSG
MELVIN B. HEYMAN, M.D.
PROFESSOR OF PEDIATRICS
CHIEF, DIVISION OF PEDIATRIC GASTROENTEROLOGY,
HEPATOLOGY AND NUTRITION
Please see the next page for important information regarding this cost center.
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INSTRUCTIONS: Cost Center 813 (continued):
The following complete attestation is to be added for this cost center when the report is
dictated by a fellow or resident. Please add this attestation in its entirety. The ATTENDING
will fill in the information, NOT the transcriptionist. The attestation is located in WS normals as
“attesttext.” You will not use the “attest” statement or “pedsattest” for this cost center. This
attestation text is positioned under the attending physician’s signature block. This is the only
time text will go underneath the signature block.
I discussed the findings with Dr. ________________ (attending MD must fill in
the resident fellows name.)
 Delete the cues in the parenthesis after you have filled in the
resident/fellows name.
I personally performed the key elements of the history with the patient,
including: (attending MD must fill in at least 2 history findings either positive or
negative).
 Delete the cues in the parenthesis after you have filled in the history
elements.
I have personally completed a physical exam of the patient. The key elements
include: (attending MD must fill in normal or abnormal findings for a least 2
organ systems).
 Delete the cues in parenthesis after you have filled in the 2 organ
systems.
I agree with the assessment and plan to: (attending MD must fill in the
assessment and plan).
 Delete the cues in parenthesis after you have filled in the assessment
and plan.
Any specific clarifications or additions are listed below:
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Rev. 09/21/10
Confidential Property of Acusis