Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Biopsy


Related Terms

  • Tissue Sample
  • Tissue Sampling

Specialists

  • Dermatologist
  • General Surgeon

Comorbid Conditions

Factors Influencing Duration

Factors influencing disability include the presence of complications, the type of procedure used, site of procedure, and severity of underlying condition making biopsy necessary.

Medical Codes

ICD-9-CM:
01.11 - Closed [Percutaneous] [Needle] Biopsy of Cerebral Meninges; Burr Hole Approach
01.12 - Open Biopsy of Cerebral Meninges
01.13 - Closed [Percutaneous] [Needle] Biopsy of Brain; Burr Hole Approach; Stereotactic Method
03.32 - Biopsy of Spinal Cord or Spinal Meninges
05.11 - Biopsy of Sympathetic Nerve or Ganglion
06.11 - Closed (Percutaneous) (Needle) Biopsy of Thyroid Gland; Aspiration Biopsy of Thyroid
06.12 - Open Biopsy of Thyroid Gland
06.13 - Biopsy of Parathyroid Gland
07.11 - Closed [Percutaneous] [Needle] Biopsy of Adrenal Gland
07.12 - Open Biopsy of Adrenal Gland
07.15 - Biopsy of Pituitary Gland, Unspecified Approach
07.16 - Biopsy of Thymus
22.11 - Diagnostic Procedures on Nasal Sinus; Closed [Endoscopic] [Needle] Biopsy of Nasal Sinus
22.12 - Diagnostic Procedures on Nasal sinus; Open Biopsy of Nasal Sinus
25.02 - Diagnostic Procedures on Tongue; Open Biopsy of Tongue; Wedge Biopsy
26.11 - Closed (Needle) Biopsy of Salivary Gland or Duct
27.22 - Biopsy of Uvula and Soft Palate
27.23 - Biopsy of Lip
27.24 - Biopsy of Mouth, Unspecified Structure
28.11 - Biopsy of Tonsils and Adenoids
31.43 - Closed (Endoscopic) Biopsy of Larynx
31.44 - Closed (Endoscopic) Biopsy of Trachea
33.24 - Closed [Endoscopic] Biopsy of Bronchus; Bronchoscopy (Fiberoptic) (Rigid) with: Brush Biopsy of "Lung"; Brushing or Washing for Specimen Collection; Excision (Bite) Biopsy; Diagnostic Bronchoalveolar Lavage (BAL); Mini-Bronchoalveolar Lavage [Mini-BAL]; Transbronchoscopic Needle Aspiration [TBNA] of Bronchus
33.26 - Closed [Percutaneous] [Needle] Biopsy of Lung; Fine Needle Aspiration (FNA); Transthoracic Needle Biopsy of Lung (TNNB)
33.27 - Closed Endoscopic Biopsy of Lung; Transbronchoscopic Needle Aspiration [TBNA] of Lung
34.24 - Pleural Biopsy, Other
38.21 - Biopsy of Blood Vessel
40.11 - Biopsy of Lymphatic Structure; Transbronchoscopic Needle Aspiration [TBNA] of Lymph Node
41.31 - Bone Marrow Biopsy
41.32 - Closed (Aspiration) (Percutaneous) Biopsy of Spleen
42.24 - Closed (Endoscopic) Biopsy of Esophagus; Brushing or Washing for Specimen Collection; Esophagoscopy with Biopsy; Suction Biopsy of the Esophagus
44.14 - Closed (Endoscopic) Biopsy of Stomach; Brushing or Washing for Specimen Collection
45.14 - Closed [Endoscopic] Biopsy of Small Intestine; Brushing or Washing of Specimen Collection
48.25 - Open Biopsy of Rectum
49.23 - Biopsy of Anus
50.11 - Closed (Percutaneous) (Needle) Biopsy of Liver
51.12 - Percutaneous Biopsy of Gallbladder or Bile Ducts; Needle Biopsy of Gallbladder
52.11 - Closed (Aspiration) (Needle) (Percutaneous) Biopsy of Pancreas
52.12 - Open Biopsy of Pancreas
55.23 - Closed [Percutaneous] [Needle] Biopsy of Kidney; Endoscopic Biopsy via Existing Nephrostomy, Nephrotomy, Pyelostomy, or Pyelotomy
55.24 - Open Biopsy of Kidney
57.34 - Open Biopsy of Bladder
60.11 - Closed [Percutaneous] [Needle] Biopsy of Prostate; Approach: Transrectal, Transurethral; Punch Biopsy
60.12 - Open Biopsy of Prostate
62.11 - Closed [Percutaneous] [Needle] Biopsy of Testis
65.11 - Aspiration Biopsy of Ovary
65.12 - Other Biopsy of Ovary
67.11 - Endocervical Biopsy
68.13 - Open Biopsy of Uterus
70.24 - Operations on Vagina and Cul-de-sac, Vaginal Biopsy
71.11 - Biopsy of Vulva
83.21 - Open Biopsy of Soft Tissue
85.11 - Closed [Percutaneous] [Needle] Biopsy of Breast
86.11 - Closed Biopsy of Skin or Subcutaneous Tissue

Overview

Biopsy is a procedure that is done to obtain a sample of tissue (cells) for examination in a laboratory. In most cases, a biopsy is obtained to assist the physician in making a diagnosis. For instance, a tumor sample can be examined to determine if it is cancerous (malignant) or noncancerous (benign). A biopsy can also be obtained to evaluate the severity or extent of a disease (for example, a biopsy of the liver or kidney). Biopsy of a nerve or muscle may help diagnose certain neurological or muscular conditions, such as neuropathy or myopathy. Biopsy of skin or other tissue that contains blood vessels may help diagnose inflammation of the arteries (arteritis) seen in Takayasu's arteritis, giant cell arteritis, temporal arteritis and polyarteritis nodosa, for example. Bone marrow biopsy can help explain certain hematological conditions affecting the blood, such as anemia, polycythemia, or leukemia. Biopsy of tissue lining a joint space (synovium) is helpful in diagnosing arthropathies. A final common reason to obtain a biopsy is to assess the effectiveness of certain medical treatments. For example, after chemotherapy for cancer, the physician may biopsy the affected tissues to see if the cancer has been destroyed.

There are several ways of approaching a biopsy sample: fine needle (a small bore needle is inserted through the skin into the tissue in question), core needle (a wide bore needle is inserted through the skin into the tissue in question to acquire a piece of tissue larger than could be acquired through a fine needle), or open biopsy (in which an incision in made through the skin and the surgeon removes samples of the tissue in question). The type of approach used in acquiring the biopsy sample depends on the diagnosis being considered and on whether there is concern about spreading tumor cells along the needle tract. A biopsy usually can be obtained on an outpatient basis, except for the open biopsy, which is done as part of a surgical operation under general anesthesia. The biopsy procedure may be guided by various ancillary techniques, such as ultrasound (ultrasound-guided biopsy), magnetic resonance imaging (MRI-guided biopsy) or computed tomography (CT-guided biopsy), in order to increase the chances of identifying abnormal tissue and sampling it.

Source: Medical Disability Advisor



Reason for Procedure

Biopsies are done to obtain samples of tissues for further evaluation in a laboratory. This is commonly done to help the physician make a diagnosis, to help determine the severity or extent of a disease, to evaluate the effectiveness of certain treatments, or to determine the cause of certain inflammations or infections.

Source: Medical Disability Advisor



How Procedure is Performed

The details of the procedure vary, depending on the tissue being biopsied. For a skin or muscle biopsy, the skin over the area being sampled is sterilized, usually with an iodine solution. The area is then numbed (anesthetized) with local anesthetic. A small piece of tissue is cut away with a sterile scalpel, and the small wound is stitched (sutured) closed. In the skin biopsy technique called "shave biopsy," a partial-thickness piece of skin is removed with a scalpel and the wound is not sutured but is covered with a light dressing. In the skin biopsy technique called "punch biopsy," a small piece of skin is removed with a circular instrument called a punch. The resulting wound can be sutured or dressed with a light bandage.

For a needle biopsy, the skin over the area being sampled is sterilized and numbed (anesthetized). A sterile needle is inserted through the skin and into the tissue being sampled. The needle containing the sample is removed, and the wound is covered with a bandage.

An open biopsy is done under general anesthesia, as part of a surgical operation. A sample of the tissue is cut away during the surgery. The whole lump or suspicious area may be removed (excisional biopsy), or only a portion of the lump may be removed (incisional biopsy). If the remainder of the procedure depends on what the biopsy reveals, as in the case of breast removal (mastectomy) for a malignant tumor, a frozen section of cells from the biopsy is examined immediately by a pathologist for a preliminary reading. Frozen-section diagnosis is not as reliable as fixed-tissue diagnosis, which takes longer because the cells are subjected to different staining procedures. Final diagnosis awaits examination of the fixed section.

Endoscopic biopsy is done through a fiber-optic instrument (endoscope) inserted into the gastrointestinal tract (gastrointestinal endoscopy), urinary bladder (cystoscopy), abdomen (laparoscopy), joint cavity (arthroscopy), midportion of the chest (mediastinoscopy), windpipe and airway (laryngoscopy and bronchoscopy), or uterus (colposcopy).

Skin, muscle, and needle biopsies are generally done as outpatient procedures, under local anesthetic.

Source: Medical Disability Advisor



Prognosis

The prognosis is dependent on the type of biopsy. For needle and incisional biopsies, recovery is based on the normal healing process which is usually 14 days to suture removal. For endoscopic biopsies, the healing is usually not directly observable. For excisional biopsies of small masses, the recovery may be 2 to 4 weeks. For excisional biopsies of large masses, the loss may be permanent.

Source: Medical Disability Advisor



Complications

Biopsy is generally uncomplicated unless a large mass is removed. As with all surgical techniques, the risk of infection, bleeding, scarring, and allergic reaction to anesthesia should be considered. Surgical disruption of a cancerous tumor or localized infection (abscess) rarely causes spread of cancer cells or infectious organisms.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Restrictions and accommodations are generally not needed for this procedure. Accommodations are dependent on the condition causing the need for the biopsy. If physical limitations are present, then the employer's ability to accommodate is key to early return to work.

Source: Medical Disability Advisor



Maximum Medical Improvement

14 days for superficial biopsy.
14 to 30 days for larger biopsy.
90 days for larger excisional biopsy.

Source: Medical Disability Advisor



References

General

Pillinger, John, and Philip Owen, eds. "Biopsy." NetDoctor.co.uk. Eds. John Pillinger and Philip Owen. 15 Dec. 2009. 2 Oct. 2013 <http://www.netdoctor.co.uk/health_advice/examinations/biopsy.htm>.

Source: Medical Disability Advisor






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