This page provides General Surgery Residents with guidelines for preparing their Surgery OPERATIVE LOG Data for submission to the ACGME at the completion of training.
Only one resident may take credit as surgeon for each operation and only for one procedure in a multi-procedure operation. On same patient/same day/same operation a senior resident may take credit as surgeon while another resident takes credit as a First Assistant, or a senior resident may take credit as a Teaching Assistant while a more junior resident takes credit as a surgeon.
SC = Surgeon Chief Year (only cases credited as surgeon during 12 months of Chief Year)
SJ = Surgeon Junior Years (all cases credited as surgeon prior to Chief Year)
TA = Teaching Assistant (more senior resident working with junior resident who takes credit as surgeon)
FA = First Assistant (any instance in which a resident assists at an operation with another surgeon---an attending or more senior resident---responsible for the operation).
DC Minimums (General Surgery Defined Category Mappings)
Found on ACGME website
Residents are expected to log the following number of TTL MAJ (see defined category report) cases by the end of each post-graduate (PG) year. The TTL MAJ category is comprised of all Surgeon Chief, Surgeon Junior, and the first 50 Teaching Assistant cases up to and including Operative Trauma.
PGY-1 - 150
PGY-2 - 300
PGY-3 - 500
PGY-4 - 800
PGY-5 - 1050+
Log Non-Operative Trauma Cases: Select CPT Code # 99199
Guidelines include:
The category, major organ trauma, no operation required, is defined as patients with major organ trauma who were admitted to a specialty care unit in the hospital, ie, SICU, CCU, Burn Unit, etc.
The most senior resident on the trauma service should claim credit for the MOTNOR case. In the instance where there is no trauma service, a fourth or fifth year general surgery resident may claim credit.
If the patient subsequently requires a general surgery operative procedure that may be claimed in the defined category, "Trauma, operative," then this case should be recorded as "Trauma," and not as MOTNOR.
Select CPT Code #99292
Critical Care Cases
For your Residency training, the ACGME requires you to do at least 40 Critical Care index cases (CPT code 99292). Within this code category you will be prompted to select an RRC code to map to the 99292 CPT code. You should have at least 2 RRC codes selected per patient out of the seven available categories. Detailed information regarding critical care guidelines can be found under the 'procedure tab' after you log into the ACGME database.
Critical Care Case Log Guidelines
The system will allow residents to identify the required minimum 40 surgical critical care index cases by using CPT Code 99292. Code 99292 will map to all seven of the surgical critical care conditions.
It is important for new users entering CPT code 99292 to understand that this index category is different from the other codes. CPT code 99292 (and it alone) will allow credit to be taken for multiple procedures on the same patient on the same day.
Reports will provide both a summary of all instances in which the resident managed 2 of the seven index critical care conditions and a detailed report for each patient encounter that will identify all the 7 conditions that were managed by the resident for any one patient.
Rrc Code Assignment to New Surgical Critical Care Procedures
Following is a list of RRC procedure values that have been assigned to the newly developed Surgical Critical Care Patient Management Procedures:
8410 - Ventilatory Management (>24 hrs on ventilator)
8420 - Bleeding (non-trauma patient >3 units)
8430 - Hemodynamic instability (Req. Inotropic/pressor support)
8440- Organ dysfunction (renal, hepatic, cardiac failure)
8450 - Dysrhythmias (requiring drug management)
8460 - Invasive line management/monitoring (Swan-Ganz, catheter, arterial lines, etc)
8470 - Parenteral/enteral nutrition
Residents may review and request their case log reports directly from the ACGME website.
Resident Experience Report by Role
Defined Category Report
Defined Category Report for 2nd Year Residents
Resident Full Detail Report
Resident Activity Report
Critical Care Log Report