• Call: (844) 569-8628
  • |
  • Get a Quote
  • |
  • COVID-19 Updates
  • |
  • Log In
DrChrono gray logo
  • Solutions
    • Providers
    • EHR by Specialty
    • Telemedicine
    • Large Practice
    • Small Practice
    • Multi Specialty

    • Patients
    • Patient Portal - OnPatient

    • Partners & Affiliates
    • Become a Partner
    • API Developers
    • Affiliate Information
    • Apple Mobility Program
  • Platform
    • Product
    • Electronic Health Records
    • Telehealth
    • Practice Management
    • Medical Billing
    • Revenue Cycle Management
    • Patient Portal
    • Mobile EHR Solutions
    • App Marketplace

    • Features
    • All Features
    • Lab & Imaging
    • eRx & EPCS
    • Medical Templates
    • Feature videos
  • Resources
    • Resources & Tools
    • Resources
    • Case Studies
    • Blog
    • Specialties
    • Testimonials
    • Webinars
    • Plans
    • ONC Certification

    • Customer Help
    • Support Center
    • Training videos
  • Company
    • About Us
    • Blog
    • Diversity
    • Life & Culture
    • Press
  • Telehealth
  • Try Now
DrChrono gray logo mobile menu icon
Close out of menu icon
  • Solutions
    • Providers
    • EHR by Specialty
    • Telemedicine
    • Large Practice
    • Small Practice
    • Multi Specialty

    • Patients
    • Patient Portal - OnPatient

    • Partners & Affiliates
    • Become a Partner
    • API Developers
    • Affiliate Information
    • Apple Mobility Program
  • Platform
    • Product
    • Electronic Health Records
    • Telehealth
    • Practice Management
    • Medical Billing
    • Revenue Cycle Management
    • Patient Portal
    • Mobile EHR Solutions
    • App Marketplace

    • Features
    • All Features
    • Lab & Imaging
    • eRx & EPCS
    • Medical Templates
    • Feature videos
  • Resources
    • Resources & Tools
    • Resources
    • Case Studies
    • Blog
    • Specialties
    • Testimonials
    • Webinars
    • Plans
    • ONC Certification

    • Customer Help
    • Support Center
    • Training videos
  • Company
    • About Us
    • Blog
    • Diversity
    • Life & Culture
    • Press
  • Try Now Log In
Indications
• • •
INITIAL STUDY
Notes
Results
Deep Venous Thrombosis - Left Leg
Superficial Venous Thrombosis - Left Leg
Deep Venous Insufficiency - Left Leg
Superficial Venous Insufficiency - Left Leg
Deep Venous Thrombosis - Right Leg
Superficial Venous Thrombosis - Right Leg
Deep Venous Insufficiency - Right Leg
Superficial Venous Insufficiency - Right Leg
Interpretation
___ duplex imaging of the lower extremities was performed with the patient in reverse Trendelenburg.
Distal augmentation was used to elicit the presence of reflux.
No evidence of ___ venous thrombosis was noted at this time.
Left Insufficiency of
Saphenofemoral Junction (SFJ)
Saphenopopliteal Junction (SPJ)
Great Saphenous Vein (GSV) Thigh
Anterior Accessory Great Saphenous Vein (AAGSV) Thigh
Great Saphenous Vein (GSV) Calf
Small Saphenous Vein (SSV)
GSV Incompetent Perforator (GSV IPVx____)
SSV Perforator (SSV IPVx____)
Other
Venous Radiofrequency Thermal Ablation is recommended.
Venous Chemical Ablation is recommended
Right Insufficiency of
Saphenofemoral Junction (SFJ)
Saphenopopliteal Junction (SPJ)
Great Saphenous Vein (GSV) Thigh
Anterior Accessory Great Saphenous Vein (AAGSV) Thigh
Great Saphenous Vein (GSV) Calf
Small Saphenous Vein (SSV)
GSV Incompetent Perforator (GSV IPVx____)
SSV Perforator (SSV IPVx____)
Other
Venous Radiofrequency Thermal Ablation is recommended.
Venous Chemical Ablation is recommended
CEAP CLASSIFICATION
• • •
VCSS (VENOUS CLINICAL SEVERITY SCORE) - LEFT LE
VCSS (VENOUS CLINICAL SEVERITY SCORE) - RIGHT LE
LEFT DEEP VEINS
CFV - REFLUX (ms) milliseconds
INSUFFICIENT
FV - REFLUX (ms) milliseconds
INSUFFICIENT
POP V - REFLUX (ms) milliseconds
INSUFFICIENT
RIGHT DEEP VEINS
CFV - REFLUX (ms) milliseconds
INSUFFICIENT
FV - REFLUX (ms) milliseconds
INSUFFICIENT
POP V - REFLUX (ms) milliseconds
INSUFFICIENT
LEFT SUPERFICIAL VEINS
SFJ - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
GSV PROX TH - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
GSV MID TH - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
GSV KNEE - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
GSV MID CALF - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
AAGSV - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
_____(VV) Thigh
REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
_____(VV) Calf
REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
SSV FOSSA/ SPJ - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
SSV MID CALF - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
RIGHT SUPERFICIAL VEINS
SFJ - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
GSV PROX TH - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
GSV MID TH - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
GSV KNEE - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
GSV MID CALF - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
AAGSV - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
_____(VV) Thigh
REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
_____(VV) Calf
REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
SSV FOSSA/ SPJ - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
SSV MID CALF - REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
LEFT PERFORATORS
GSV PERFORATOR - LOCATION
REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
SSV PERFORATOR - LOCATION
REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
ACCESSORY PERFORATOR - LOCATION
REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
RIGHT PERFORATORS
GSV PERFORATOR - LOCATION
REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
SSV PERFORATOR - LOCATION
REFLUX (ms) milliseconds
DIAMETER (mm) millimeters
ACCESSORY PERFORATOR - LOCATION
REFLUX (ms) milliseconds
DIAMETER (mm) millimeters

PS LOWER EXTREMITY VENOUS INSUFFICIENCY DUPLEX Medical Form

Vascular Surgeon

mdhg

There are 3 copies in use.
Published: April 2, 2024, 7:09 p.m.
Doctor: Dr. History Physical
Rating: 0   /

Use this form Back to list

Download PS LOWER EXTREMITY VENOUS INSUFFICIENCY DUPLEX

If you have an account, log in to use or rate this form. Log In

Click to use an int'l or other #

Don't have an account? Sign up to use this form. Sign Up

Close
DrChrono white logo

328 Gibraltar Dr
Sunnyvale, CA 94089

Call us: (844) 569-8628

Apple app store logo
  • Free EHR Demo
  • EHR
  • Practice Management
  • Medical Billing
  • Revenue Cycle
    Management
  • Patient Portal
  • Mobile EHR
  • eRx
  • Plans
  • EHR Features
  • Lab & Imaging
  • Patient Education Materials
  • Universities & Schools
  • Security Policy
  • SSO Log In
  • EHR Checklist
  • Meaningful Use
  • EPCS
  • MACRA & MIPS
  • ICD-10 Info
  • Share your Experience
  • OnPatient Portal
  • OnPatient Terms of Use
  • OnPatient Privacy Policy
  • Security Policy
  • Support Center
  • Developer API & SDK
  • EHR FAQ
  • Medical Billing Calculator
  • Medical Form Library
  • Insurance Lookup
  • ICD & HCPCS Lookup
  • App Directory
  • About Us
  • News & Updates
  • Careers
  • Contact Us
  • Testimonials
  • Logos & Branding
  • Our Flickr
  • Press
© Copyright 2019 DrChrono Inc.
  • Privacy Policy
  • Terms of Use
  • Site Map
  • twitter icon
  • facebook icon
  • youtube icon