If the tear is diagnosed later a ligament reconstruction might be . Bethesda, MD 20894, Web Policies S63.641A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. What can I text my friend to make her smile? This means you can usually return home the same day. Discover how to save hours each week. 2022 Mar;10(3):267-271. doi: 10.22038/ABJS.2021.52295.2583. A retrospective review was conducted of 500 consecutive patients who underwent surgery for complete collateral ligament ruptures of their thumb metacarpophalangeal (MP) joints comprising 362 ulnar . $3,665 . Like most surgeries, the UCL reconstruction comes with the risk of infection and issues related to anesthesia. The InternalBrace surgical technique is intended only to augment the primary repair/reconstruction by expanding the area of tissue approximation during the healing period and is not intended as a replacement for the native ligament. There is a lot of good info about wrist arthroplasties. This can lead to pain, a sense of instability or looseness, and an inability to work or play sports. For a metacarpophalangeal joint ulnar collateral ligament sprain, you would use code 842.12. 2021 Jun 9;3(5):278-281. doi: 10.1016/j.jhsg.2021.05.007. For a metacarpophalangeal joint ulnar collateral ligament sprain, you would use code 842.12. Complete rupture can be a debilitating injury, resulting in decreased grip and pinch strength. The soft tissue was pulled proximally and pinched into the bed of origin. Martin A. Posner. Ulnar collateral ligament sprain of right elbow, initial encounter S53.441D Ulnar collateral ligament sprain of right elbow, subsequent encounter . You may see bruise-like discolorations on the skin around the joint. The loose end of the torn ligament may form a bump that can be felt along the edge of the thumb near the palm of the hand. It is performed under general anesthesia and may last anywhere from 60 to 90 minutes. Sometimes also referred to as the ulnar collateral ligament (UCL), the MCL of the elbow attaches the ulna (which, along with the radius, makes up the bones of the lower arm) to the humerus, the bone of the upper arm. The addition of the internal brace . Ulnar collateral ligament (UCL) tears of the thumb are common injuries. The collateral ligaments consist of a strong proper collateral ligament and a weaker accessory collateral ligament. The one on the medial side is called the medial (or ulnar) collateral ligament and the one on the lateral side is called the lateral (or radial) collateral ligament. To repair the UCL ligament of the thumb involves reattaching the torn ligament, usually with internal sutures. The lateral collateral ligament (LCL) of the elbow is the ligament on the outside of the elbow, not to be confused with the LCL in the knee. Ligament / Volar Plate CPT Codes Late effect of dislocation (nonspecific) (905.6) Repair lateral collateral ligament, elbow, with local tissue (24343) Repair lateral collateral ligament, elbow, with tendon graft, including graft harvest (24344) Repair medial collateral ligament, elbow, with local tissue (24345) Creation of a Stener lesion, as found in Gamekeeper's thumb, requires combined tears of the proper and accessory ulnar collateral ligaments in order for the ligament to be displaced by the adductor aponeurosis. 2016;4(3)(suppl3):2325967116S00071. This study aimed to clarify what selective contraction of the forearm muscles makes FPMs harder relative to UCL. 10.8 After the final repair, the thumb is showing no laxity on valgus stress test. Surgical Procedures on the Hand and Fingers. But thanks to a new procedure used to fix his torn ulnar collateral ligament, his recovery could . Right after the surgery, the elbow is secured in a brace at a 60- to 90-degree angle. Trigger thumb, right thumb M65.312 Trigger thumb, left thumb M65.321 . The accepted current procedural terminology (CPT) for UCLR (24346) was used to search the database. When the tear results in pain and instability, surgical repair offers a predictably successful outcome. 1012, Fig. February 27, 2023 equitable estoppel california No Comments . The joint is stabilized by the UCL and radial collateral ligament (RCL), the volar plate, and the dorsal capsule. Diagnosis relies upon thumb MCP radial-ulnar stress exam and MRI studies. The ligament helps keep the outer side of your knee joint stable. Orthop J Sports Med. Diagnosis relies upon thumb MCP radial-ulnar stress exam and MRI studies. Report RCL or LCL tears with 24343 (for repair) or 24344 (for reconstruction). eCollection 2022 Jan. J Hand Microsurg. This yielded 655 results of 647 unique patients. He immediately knew something was wrong. Complications after this procedure may include nerve or blood vessel damage. Comparison of results after surgical repair of acute and chronic ulnar collateral ligament injury of the thumb. The technical term for a torn ligament in the thumb is an ulnar collateral ligament injury of the thumb. Diagnosis is usually made by a combination of physical exam and MRI studies. 10.6 The UCL is repaired with the PDS knot visible. Thumb Collateral Ligament Injuries, most commonly ulnar collateral (UCL), are athletic injuries that lead to a decrease in effective thumb pinch and grasp. The .gov means its official. De Giacomo AF, Shin SS. You will wear your splint at all times for 6 weeks. At final follow-up, radiographs showed no implant complications, no osteoarthritic changes in MCP joints, and stress testing showed that all patients had normal stability in the treated thumb when compared with the untreated thumb. 1018, Fig. Disclaimer. Next, the isometric access was identified and holes were pre-drilled for the insertion of the second part of the InternalBrace while holding the reduction in place. Sometimes the surgeon will attach the remnants of the original ligament to the graft, reinforcing the structure. Article. UCL injuries comprises of 86% of all athletic thumb injuries, acute injuries are common in many contact and non-contact sports, chronic injuries due to attenuation of the ligament under repeated stress, radially-directed force causing hyper-abduction moment, i.e. Augmenting the repair with an Internal Brace ligament augmentation results in a strong construct that allows for early motion and limited postoperative immobilization. The AHA Coding Clinic for HCPCS includes: Thank you for choosing Find-A-Code, please Sign In to remove ads. Treatment. 106, Fig. Refractive lens (change of intraocular lens) (Price of one eye) CPT: 66986 . 1019. Bone-periosteum-bone graft reconstruction for chronic ulnar instability of the metacarpophalangeal joint of the thumb--minimum 5-year follow-up evaluation. 10.7 Repair of the adductor aponeurosis with a 6.0 PDS running stitch. When a right elbow lateral collateral ligament repair with both local tissue and application of an InternalBrace is performed, is the procedure reported with CPT code 24343 or is it more appropriate to report the unlisted code, 24999, since they are using an InternalBrace in addition to local tissue? baseball players that underwent primary UCLR from 2011-2020 at across two institutions were identified using the CPT code 24346. The ulnar collateral ligament is a strong band that is attached to the middle joint of the thumb (metacarpophalangeal joint). How do you treat a torn ligament in your finger? Address : 823 129th Infantry Drive,Suite 103, Joliet, IL 60435. Dr. Dugas performs an InternalBrace ligament augmentation repair by forming a bone socket in the sublime tubercle with a special drill, guide, and tap, and then places a 3.5 mm PEEK SwiveLock anchor loaded with collagen-coated FiberTape suture and a #0 FiberWire suture repair stitch. The AHA Coding Clinic for HCPCS includes: The official publication for Level I HCPCS (CPT-4 codes) for hospital providers. Fig. In these cases, a new graft may be used to perform a second reconstruction. doi:10.1177/2325967116S00071. One should make a comparison with the uninjured contralateral thumb. Potential complications may also arise from the graft harvesting site, but they are also rare and can usually be resolved with medication. Walters BL, Cain EL, Emblom BA, Frantz JT, Dugas JR. Ulnar collateral ligament repair with InternalBrace augmentation: a novel UCL repair technique in the young adolescent. The ulnar collateral ligament complex is located on the inside of the elbow (pinky or medial side). Codes are selected based on the . The ICD-10-CM code T67.4 . Laxity of over 35 degrees with no clear endpoint signifies rupture (Fig. This injury may be treated by. Thumb metacarpophalangeal joint (MCPJ) collateral ligament repair is a treatment option in acute complete ligament tears and those associated with Stener lesions or MCPJ subluxation. In such cases splinting is typically required for 3-6 weeks. Accompanying fractures The ulnar collateral ligament (UCL) or internal lateral ligament is a thick triangular ligament at the medial aspect of the elbow uniting the distal aspect of the humerus to the proximal aspect of the ulna. Clipboard, Search History, and several other advanced features are temporarily unavailable. Here in the figure, the proximal end of the UCL is held with forceps. The sequence of repair in both scenarios is illustrated in Fig. If this is your first visit, be sure to check out the. J HAND SURG-AM. government site. In most instances, a throwing athlete can gradually return to competitive throwing between six and nine months following a Tommy John Surgery. Augmenting the repair with an InternalBrace ligament augmentation results in a strong construct that allows for early motion and limited postoperative immobilization.1. Arthrex has developed the Thumb Metacarpophalangeal (MCP) Joint Ulnar Collateral Ligament (UCL) Repair using either a 2.5 mm PushLock Knotless Suture Anchor, a Micro/Mini BioComposite SutureTak , a Micro/Mini FT Corkscrew or FASTak anchors. The LCL in the elbow is sometimes also called the radial collateral ligament (RCL). Certain products may not be approved for sale in all countries. This surgery takes approximately 1 hour, and is performed as an outpatient surgery, meaning you will be able to go home that day. Lateral collateral ligament complex On the lateral side of the elbow joint, the LCL complex is comprised of three primary structures: the radial collateral ligament proper (RCL), the annular ligament (AL), and the lateral ulnar collateral ligament (LUCL) (Fig. Ice should be applied to the injured site for 1520 minutes every 12 hours using a bag of frozen peas in a moist cloth or towel or by submerging the finger in a cup of ice with a little bit of water. DX code 841.1 is not correct for THUMB collateral ligament sprain. To read the full article, sign in and subscribe to the AHA Coding Clinic for HCPCS. In addition, the ulnar nerve may be irritated as a result of the elbow injury. Eventually this abnormal movement will wear out the joint and it will become arthritic. Ebrahimpour A, Okhovatpour MA, Tabrizi A. Arch Bone Jt Surg. CPT Code 26540 Repair, Revision, and/or Reconstruction Procedures on the Hand and Fingers Codify by AAPC. Black And White Aesthetic StickersPrintable, Mississippi State Women's Basketball Roster 2019, Esthetician For African American Skin Near Me, Aaliyah: The Princess Of R&B Full Movie Putlockers, Crystal Fairy & The Magical Cactus Watch Online, High School Wrestling Weight Classes 2020, University Of Miami Supplemental Essays 2021, TCU Horned Frogs Women's BasketballBasketball Team, Logical Connectives In Discrete Mathematics, Drawing On The Right Side Of The Brain Starter Kit, Presentacin gua para PYMES ante los ODS en CAEB, Innovation Strategies reconocida como Great Place to Work. thumb metacarpophalangeal ulnar collateral ligament tears. A proximally based and distally based rectangular flap containing the UCL remnants is elevated exposing the metacarpophalangeal joint. The most common symptoms associated with UCL injuries are swollen, painful joint, and weakness to thumb especially with gripping or pinching, as well as bruising. Your lifting restrictions will gradually be increased over the next 2-3 months. The primary role of the MCPJ of the thumb is flexion and extension. The most common ones are the docking technique and the figure-eight technique. There was an error retrieving the content. Read on for more information on causes, symptoms and treatments. Gamekeeper's thumb (or Skier's thumb) is a condition wherein the ulnar collateral ligament (UCL) of the thumb is torn at the point where the thumb joins the hand at the metacarpal phalangeal joint (MCP). WoulD cpt CODE 26540 be the correct code ? registered for member area and forum access. Fig. 104, Fig. Fig. MCL Injuries of the Elbow (It should not be confused with the MCL of the knee.) Primary Results of Hook Plate Fixation Technique for Ulnar Collateral Ligament Fracture-Avulsion: A Case Study. We NEVER sell or give your information to anyone. Injury to this ligament is commonly due to any hard force put on that thumb that causes the thumb to be pulled away from the palm of the hand, usually a result of a sports related injury. The goal is to protect the healing tissue and reduce inflammation. Fig. When the tear results in pain and instability, surgical repair offers a predictably successful outcome. Clavicle ORIF. Copyright 2023 Lineage Medical, Inc. All rights reserved. We present a novel technique to augment the repair of the UCL with suture tape to provide immediate biomechanical support and strength during the critical time of ligament healing. Her areas of expertise include physician audits and education, compliance and HIPAA legislation, litigation support for Medicare self-disclosure . Arthroscopy 1999;15:333 . Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. What is the application of a cascade control system. The code is valid during the fiscal year 2023 from October 01, 2022 through September 30, 2023 for the submission of HIPAA-covered transactions. Epub 2014 Oct 22. 10.19 Illustration of Mitek mini anchor. Orthop Clin North Am. shaka wear graphic tees is candy digital publicly traded ellen lawson wife of ted lawson cpt code for scapholunate ligament repair 25 Feb/23 (No Ratings Yet) Fig. When the ulnar collateral ligament of the thumb is injured, the MCP joint becomes painful and swollen, and the thumb feels weak when you pinch or grasp. Tommy John didnt invent this procedurehe was a baseball pitcher who was the first to undergo it and successfully return to his sport. Patient had a history of injury to the thumb ulnar collateral ligament. Midterm clinical outcomes of collateral ligament repair of the thumb and lesser digits: a retrospective analysis of 35 cases. : Keep post-operative dressing clean, dry, and in place Keep hand elevated above the level of your heart May use hand for very light activities of daily living, such as eating, writing, typing, getting dressed, and brushing teeth Day 7-14: For a better experience, please enable JavaScript in your browser before proceeding. A torn ligament in the thumb can temporarily cause your hand to lose the ability to pinch and grasp objects. Such overuse injuries are common in baseball pitchers and other athletes who experience a lot of bending in the elbow. To test for joint stability, one should test by fully flexing the MCPJ and should apply valgus stress to the thumb to test the proper collateral ligament. When the tear results in pain and instability, surgical repair offers a predictably successful outcome. The adductor aponeurosis is identified and separated from the joint capsule. Tension sutures are placed proximally and distally through the graft and soft tissue. It occurs when the aponeurosis of the adductor pollicis muscle becomes interposed between the ruptured ulnar collateral ligament (UCL) of the thumb and its site of insertion at the base of the proximal phalanx. (OBQ10.213) [Treatment of ulnar collateral ligament avulsion fracture of thumb metacarpophalangeal joint using a combination of Kirschner wire and silk tension band]. It is important that you do not submerge your surgical incision in water (i.e. Also specific Level II HCPCS codes for hospitals, physicians and other health professionals. 1011, Fig. 1010, Fig. You can start physical therapy right away, focusing on your wrist, fingers, shoulder and biceps to help avoid muscle atrophy. After 6 weeks, you will be referred for Occupational Therapy of the affected hand and wrist. Poltica de cookies. Surgical Technique Videos | Presenter: Damon Adamany, MD, Surgical Technique Videos | Presenter: Steven S. Shin, MD, Video Series | Presenter: Christopher Adams, MD. 10.3 After the skin incision, the adductor aponeurosis and hematoma are visualized; it is important not to divide the terminal branch of the superficial branch of radial nerve (SBRN) and retract it to one side. 10.1 Ulnar Collateral Ligament Repair Acute rupture of the metacarpophalangeal joint (MCPJ) ulnar collateral ligament (UCL) also known as Skier thumb is a result of forced abduction that can further result in a UCL tear. medial Compression can be applied with a firm elastic bandage around the finger. . 4b). For a sprain of the thumb, look at which joint is noted in the OP Note. An acute injury of this ligament is often amenable to primary repair. The elbow was then reduced and a horizontal stitch was placed through the origin of the lateral collateral ligament and tied off using FiberWire suture. What are the 5 objectives of physical development? Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on 10 Thumb MCP Joint Ulnar Collateral Ligament Repair, Hand Trauma: Illustrated Surgical Guide of Core Procedures. It may not display this or other websites correctly. Bookshelf The UCL is located on the inner side of the elbow, which is also where the ulnar nerve passes around the elbow joint. To provide additional strength, the dorsal joint capsule should also be repaired. The primary role of the MCPJ of the thumb is flexion and extension. Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament: Early Outcomes of Suture Anchor Repair with Suture Tape Augmentation. On the 3rd image, attenuated midsubstance radial collateral ligament (RCL) fibers are present (red arrowhead). 1013, Fig. Because of this, it is critical that these injuries receive appropriate attention and treatment. We use cookies to ensure that we give you the best experience on our website. Thumb instability resulting from disruption of the UCL profoundly impairs the overall function of the involved hand. Fig. , These injuries are especially common in athletes. To read the full article, sign in and subscribe to the AHA Coding Clinic for HCPCS. For a sprain of the thumb, look at which joint is noted in the OP Note. or Under Arthroscopy: 29834 Arthroscopy, elbow, surgical; with removal of loose body or foreign body. Skier's Thumb: Acute UCL Injury A skier's thumb injury is described as an acute injury to the ulnar collateral ligament. MRI of the elbow (T1 weighted) showing an unimpaired radial collateral ligament and extensor tendon.Radial collateral ligament of elbow joint. Get timely coding industry updates, webinar notices, product discounts and special offers. Epub 2014 Dec 30. Ex: 76641 Category II Codes Provides supplementary tracking codes that are designed for use in performance assessment and quality improvement activities. . 1015, Fig. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Treatment for most individuals is rest and physical therapy. Rest involves not using your finger. If you continue to use this site we will assume that you are happy with it. J Hand Surg Am. E.g. If you are an athlete, you may need a longer rehabilitation before you can return to your sport. S63.649D is a billable ICD-10 code used to specify a medical diagnosis of sprain of metacarpophalangeal joint of unspecified thumb, subsequent encounter. A 27-year-old competitive skier fell one week ago onto his right hand. The previously placed anchor and FiberTape suture span the repaired ligament and a second 3.5 mm PEEK SwiveLock anchor is placed after appropriate tensioning. A tear to this ligament can be painful and may make your thumb feel unstable. DX code 841.1 is not correct for THUMB collateral ligament sprain. For an avulsion fracture of the UCL, one must assess the size of the bony fragment. Cancel anytime. Current newsletters added each quarter. Treatment involves anatomic repair or reconstruction which reliably restores the essential function of the collateral ligament. It is important to elevate your arm on a couple of pillows to alleviate pain and swelling. 101). CPT code 24346 is defined as: "Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)." A total of 187 patients (188 elbows) were identified. Please try again, or try refreshing the page. Bony Mallet Fracture CRPP. This code (841.1) pertains to the elbow and forearm/wrist area. Is the radial collateral ligament medial or lateral? Is the ulnar collateral ligament medial or lateral? This code (841.1) pertains to the elbow and forearm/wrist area. 1. 2017;21(4):164-166. doi:10.1097/BTH.0000000000000173. Ulnar collateral ligament (UCL) injuries of the metacarpophalangeal (MCP) joint of the thumb are common. When the ligament is torn, the tether is too long and the bones move too much. The site is secure. official website and that any information you provide is encrypted The goal of the surgery is to stabilize the elbow, reduce or eliminate pain and restore stability and range of motion. Call Now: (855) 558-4263 (817) 382-6789 . Unable to load your collection due to an error, Unable to load your delegates due to an error. Rozmaryn LM, Wei N. Metacarpophalangeal arthroscopy. The ulnar collateral ligament (UCL) is a ligament that runs on the inner side of the elbow to help support it when performing certain motions, such as throwing. Conservative treatment such as splinting and buddy taping is recommended by most surgeons for stable partial collateral ligament tears and for tears with non-displaced or minimally displaced avulsion fractures. Nonsurgical treatment can be considered in partial tears of the UCL, which usually involve an isolated rupture of the proper collateral portion of the ligament. What is the most common closed tendon injury of the finger? National Library of Medicine Category I CPT Codes Consist of six main sections known as Evaluation and Management, Anesthesia, Surgery, Radiology, Pathology and Laboratory, and Medicine. Typically follow up appointments are scheduled in two-week intervals following surgery, so we can monitor your recovery. 10.4 Once the adductor aponeurosis is opened, access to UCL can be achieved. This force can result in a partial tear of the UCL (ulnar collateral ligament) or a complete tear of the UCL, known as a rupture. J Hand Surg Am 1995;20:1037-1042. Previous reports show an incidence of collateral ligament injuries as high as 86% of the injuries to the thumb. 2008 May-Jun;33(5):760-70. doi: 10.1016/j.jhsa.2008.01.037. The tendon used to replace the torn UCL is called a graft. Have an Arthrex representative contact me. By the end of the first month, you may be able to fully extend your elbow and eventually stop wearing the brace. After showering, pat incision dry and replace splint. excellent rate of return to sport without residual laxity or disability, >90% with outcomes rated excellent for UCL repair, 96% good to excellent outcomes for RCL repair, reconstruction of ligament with tendon graft, 100% return to sport reported in one series, salvage procedure for failed repairs or reconstructions, immobilization in splint or cast to off-load injured UCL or RCL, some protocols advocate for use of removable splint and immediate active and passive range of motion, patient must avoid stress on ligament during exercises, grip and pinch strengthening began around 4-6 weeks, straight longitudinal incision on radial aspect of the thumb, abductor aponeurosis may need to be resected to expose joint capsule and ligament, take care to spare dorsal cutaneous branches of the radial sensory nerve, pull-out sutures or loaded suture anchors can be used to re-oppose the ligament to its origin, repair MCP joint capsule and abductor tissues, K-wire may be placed to immobilize the joint temporarily, S-shaped or chevron incision overlying MCP joint, trans-osseous sutures, suture anchors with or without suture augmentation, and direct ligament repair to periosteum all described, joint immobilization leaving the IP joint free, multiple techniques described using various tissues sources, configurations and fixation constructs, palmaris longus autograft weaved through bone tunnels, can be secured with interference screws, cortical button or suture anchors, adductor aponeurosis repaired to native distal insertion of UCL, dictated by prior surgeries and concomitant pathology, various fixation methods (k-wire, compression screws, plates), MCP and IP stiffness most common complication following repair, 15% with residual instability for grade 3 injuries treated with immobilization, ligament reconstruction for chronic injuries, return to play rates approach 100% following anatomic repair, Lunate Dislocation (Perilunate dissociation), Gymnast's Wrist (Distal Radial Physeal Stress Syndrome), Scaphoid Nonunion Advanced Collapse (SNAC), Carpal Instability Nondissociative (CIND), Constrictive Ring Syndrome (Streeter's Dysplasia), Thromboangiitis Obliterans (Buerger's disease). 2009 Feb;34(2):304-8. doi: 10.1016/j.jhsa.2008.10.005. Careers. The InternalBrace technique is for use during soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation. stationary ski pole and strap contacting the moving skier's thumb into hyper-abduction, avulsed ligament with or without bony attachment is displaced dorsal and superficial to the, usually the distal end is retracted proximally, the interposed adductor will not allow healing without surgical repair, Stener-like RCL lesion rare given overlying abductor aponeurosis, RCL injury leads to joint subluxation rather than overt instability, thumb metacarpal and phalanx form the metacarpophalangeal joint, metacarpal condyles more flattened than finger metacarpals which increases stability, both ligaments run in dorsal to volar direction from proximal to distal, valgus laxity in both flexion and extension is indicative of a complete collateral rupture, diarthrodial joint but allows for six degrees of movement, flexion-extension, adduction-abduction, and rotation, static stability provided by bony anatomy, collateral ligaments, volar plate and dorsal capsule, dynamic stability provided by extrinsic and intrinsic muscle groups, extensor pollicis longus, extensor pollicis brevis, flexor pollicis longus, abductor pollicis brevis, flexor pollicis brevis, adductor pollicis, ulnar-sided tendinous/aponeurotic insertions more robust than radial, Asymmetric joint laxity but endpoint present, Joint instability without endpoint and 30-35 degrees of joint space opening or 10-15 degrees more than contralateral thumb, fall on outstretched hand and abducted thumb, tenderness at site of ligament injury (distal for UCL and proximal for RCL), stress both at extension and 30 of MCP flexion, radial instability in 30 of flexion indicates, radial instability in extension indicates, injury to accessory and proper UCL and/or volar plate, local anesthetic may be added to eliminate patient guarding, metacarpal held stationary and phalanx translated anteriorly and posteriorly, amount of translation and absence of an end point may signify volar subluxation and RCL rupture, may aid in diagnosis if a bony avulsion has already been ruled out, supination of proximal phalanx relative to the metacarpal, indicates associated dorsal capsular tear or extensor tendon injury, 81% accuracy, 74% positive predictive value, 87% negative predictive value.

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