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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.

Bronchoscopy


Text Only Home | Graphic-Rich Site | Overview | Reason for Procedure | How Procedure is Performed | Prognosis | Specialists | Comorbid Conditions | Complications | Factors Influencing Duration | Length of Disability | Ability to Work | Maximum Medical Improvement | Medical Codes | References

Medical Codes

ICD-9-CM:
33.21 - Bronchoscopy through Artificial Stoma
33.22 - Bronchoscopy
33.23 - Other Bronchoscopy
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

Related Terms

  • Bronchial Biopsy
  • Bronchus Biopsy
  • Brush Biopsy
  • Endoscopic (Closed) Biopsy
  • Endoscopic Examination of the Bronchi
  • Washing Biopsy

Overview

Image Description:
Bronchoscopy - A lighted, flexible fiber-optic tube (bronchoscope) with attached camera is shown as it passes through the mouth, through the trachea and into the lungs and bronchi of a male figure in profile lying on an examining table.
Click to see Image

Bronchoscopy is the examination or treatment of the main airways of the lungs (bronchi) by means of a rigid or fiberoptic scope (bronchoscope). Bronchoscopies are primarily performed to evaluate the appearance of the airways (for obstructions such as mucus, tumors, or foreign bodies), or to obtain specimens (lung tissues, secretions or tissues that may contain infectious agents, bronchoalveolar [BAL] lavage fluid) for analysis. A bronchial biopsy is the removal of small tissue samples of the bronchi or alveolar tissue (transbronchoscopic biopsy) for analysis.

There are two types of bronchoscopes: a rigid tube that is sometimes referred to as an open-tube ventilating bronchoscope, and a flexible fiberoptic tube. The latter has four smaller passages. Two are for light to pass through, one is for seeing through, and one can hold medical instruments that may be used for biopsy or suctioning, or through which medication can be administered. The rigid bronchoscope is only used when the patient is under general anesthesia. The flexible fiberoptic bronchoscope is more widely used, most often in outpatient settings.

Source: Medical Disability Advisor



Reason for Procedure

Bronchoscopy is used in the diagnosis and treatment of lung disorders. In addition to inspecting the bronchi for abnormalities and disease, bronchoscopy can be used to collect mucus samples, obtain samples containing cells from distant airways, or to take small samples of lung tissue for microscopic analysis. Biopsied tissue may be used to diagnose inflammation, bleeding, infections, cancer, sarcoidosis, pulmonary fibrosis, tumors, pneumonia, and other lung diseases or conditions. It may also be used to confirm the results of other tests such as a chest x-ray or a computed tomography (CT) when the diagnosis is unclear.

Bronchoscopy can also be used to remove foreign objects or thick mucus secretions. Abnormal growths can be destroyed, or damaged vessels sealed off, by means of laser (laser cauterization), heat (heat cauterization, diathermy), or freezing (cryocauterization) performed using attachments on the bronchoscope. The procedure is also recommended to determine the cause when an individual has been coughing up blood (hemoptysis).

Source: Medical Disability Advisor



How Procedure is Performed

Bronchoscopy is usually an outpatient procedure. An intravenous line may be established. Vital signs, electrocardiogram (ECG) tracings, and blood oxygen saturation are checked throughout the procedure. For fiberoptic bronchoscopy, the individual is sedated and the upper airways are numbed using a local anesthetic. In addition, local anesthetic may be applied through the bronchoscope to the air passages to suppress cough. The bronchoscope is inserted through a nostril or the mouth, past the voice box (larynx), through the windpipe (trachea), and into a bronchus. The lung passages are viewed on a monitor. Instruments can be inserted through the bronchoscope, including forceps, small cutting devices, brushes, needles, tiny tubes (catheters), and devices to perform cauterization or to collect tissue samples for biopsy. The bronchoscope can also be used in conjunction with an x-ray machine to help guide the physician to any abnormal areas of the lung (fluoroscopy).

Rigid bronchoscopy is generally performed in the operating room under general anesthesia. The tube is inserted through the mouth, and because of its larger size, additional instruments can be used.

Source: Medical Disability Advisor



Prognosis

In most cases, bronchoscopy is an effective tool in the diagnosis and treatment of lung disorders. Bronchoscopy and bronchial biopsy are routine procedures that are generally well tolerated and rarely cause complications.

Source: Medical Disability Advisor



Specialists

  • Pulmonologist
  • Thoracic Surgeon

Source: Medical Disability Advisor



Comorbid Conditions

Source: Medical Disability Advisor



Complications

Complications are rare but include cardiac arrhythmia, drug reactions, low blood oxygen, bleeding (hemorrhage), infection, perforation of the bronchus or trachea, air accumulation in the membranes surrounding the lungs (pneumothorax), pneumonia, or worsening of lung disease. There is also a risk of bleeding from the biopsy site(s).

Source: Medical Disability Advisor



Factors Influencing Duration

No disability is expected in most cases unless the individual has had complications. The length of disability may be influenced by the underlying cause for which the procedure was done, type of treatment done, and the development of complications. Duration depends on type of anesthesia (local or general), and may be longer if biopsy is done. Smoking may influence the length of disability.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

The vocal capacity of the individual may be limited for a short time following this procedure. Individuals whose job duties require use of their voice may need to be temporarily reassigned.

In addition, because of the sedative effects of the medications used during the procedure, individuals whose job duties involve any risk to themselves or others should not work until the day after the procedure.

Risk: No job would put an individual at increased risk of needing bronchoscopy.

Capacity: The bronchoscopic exam would have no long-term impact on capacity.

Tolerance: The bronchoscopic exam would have no long-term impact on tolerance.

Source: Medical Disability Advisor



Maximum Medical Improvement

1 day.

Source: Medical Disability Advisor



References

Cited

Leong, S. , et al. "Diagnostic Bronchoscopy--Current and Future Perspectives." Journal of Thoracic Disease 5 (2013): S498-S510.

General

Hadjiliadis, Denis. "Bronchoscopy." MedlinePlus. 30 May. 2013. National Library of Medicine. 6 May 2014 <http://www.nlm.nih.gov/medlineplus/ency/article/003857.htm>.

Source: Medical Disability Advisor