ORDERS ARE GOOD FOR 1 YEAR. IF EXPIRED, WE NEED TO CALL THE REFERRING DOCTOR TO GET AN UPDATED ONE.

(Refer to the Training Refresher Materials section under the Tools drop down)

Auth requirements:

Health Choice/Health Choice Generations: OB US is 5-7 days TAT, DUPLEX/DOPPLER is 5-7 day minimum TAT

Tricare: All US, MG, BD, MRI & CT require auth- 14 days minimum TAT

Alignment: US- 7 days minimum TAT

Optum: MRI, NM, PET, CTA, MRA is 14 days minimum TAT (In Nevada ONLY: Out of network for all PET, NM & US except ABI, Arterial, Venous mapping and Prostate and out of network for ALL CT except CT lung, CTA for PE, CTA runoff and patients over 400 lbs.  

Mercy Care/Mercy Care Advantage: US (Elastrography) cpt 76981 is a 14 day minimum TAT

Scan Health: ALL Breast Imaging - 7 day minimum TAT

Humana: All CT/A, MRI/A, NM Modalities are 5-7 days.

Humana FL (Only) All modalities - Schedule 9 days out.  Add-Ons ONLY allowed if patient has referral/authorization number on hand.

STAT GUIDELINES

STATS we do try to accommodate same day next day, if it requires auth we schedule out 4 hours or next AM so auth has time to attempt to obtain.

We check the location most convenient to the pt but if we see no openings we offer surrounding sites that may have openings, if surrounding do not have openings as well we are ok to double book following the below guidelines.

*Agents do not have rights to double book so if this occurs they are reaching out to their leads to do the double booking at which time the leads can check thru to make sure it’s an ok spot to add.

If they double book  they should be notifying the patient they are being worked in and may have a wait and notate this was communicated.

A call must be placed to the site only if the following circumstances apply:

·         Clinic/modality is closing within the hour. Example you get call at 3:15pm and that modality closes at 4pm.

·         We are already double-booked and you are needing to add another exam. Example we have two 4pm and you need to add a 3rd (Triple Booking).

·         Only overbook non contrast spots.  Please ensure contrast coverage is available if you are booking a contrast exam.

·         If you are scheduling a specialty exam, there may be limits on certain exams such as: Arthrograms, Fluoro, Diagnostic Mammo’s, Nuc Med, Etc. You must call the site for approval.

·         If you are scheduling an exam that requires authorization please make sure you inform the patient that if authorization is not received by the time of the exam, their appointment   may be postponed. Allow 4 business hours’ time for auth to be obtained.

·         Same day Saturday appointments that require auth must already have auth on file or the patient will not be able to be seen. If exam requires authorization and it has not already been obtained please schedule for Monday to allow time to obtain STAT auth.  

When scheduling the below STAT exam, these cannot be done after 5pm or on weekends.

CTA CHEST WITH CONTRAST W/3D RECON AND THE DIAGNOSIS IS FOR PE (PULMONARY EMBOLISM)

US DUPLEX SCAN LOWER EXTREM VEINS BILATERAL

US DUPLEX SCAN LOWER EXREM VEINS UNILATERAL (LEFT)

US DUPLEX SCAN LOWER EXREM VEINS UNILATERAL (RIGHT)

US DUPLEX SCAN UPPER EXTREM VEINS BILATERAL

US DUPLEX SCAN UPPER EXTREM VEINS UNILATERL (LEFT)

US DUPLEX SCAN UPPER EXTREM VEINS UNILATERL (RIGHT)

OB ULTRASOUNDS FOR VIABILITY

If you are “postponing scheduling” until the next business day please send recap form to the Dr office to make them aware. Please document in scheduling notes that it was completed.  If you need help please reach out to leadership.

If you are “postponing scheduling” on a Friday until Monday please send recap form to the Dr office as well as call to make them aware. Please document in scheduling notes that it was completed.  If you need help please reach out to leadership.

COMMONLY MISCHEDULED PROCEDURES

Premedication Regimen 

ASK PATIENT IF THEY ARE ALLERGIC TO IODINE. IF THEY ARE, AND HAVE SEVERE REACTIONS SUCH AS ANAPHYLACTIC SHOCK, WE WILL NOT PERFORM WITH CONTRAST. IF THEY ARE AND HAVE MILD REACTIONS,  PATIENT WILL NEED TO BE PRE-MEDICATED. 

PRE-MEDICATION REGIMEN WILL BE PREDNISONE 50MG BY MOUTH AT LEAST 13 HOURS, 7 HOURS, AND 1 HOUR BEFORE INJECTION. DIPHENHYDRAMINE (BENADRYL) 50MG BY MOUTH 1 HOUR BEFORE INJECTION. NO OTHER PREP WILL BE ACCEPTED AND MUST BE TAKEN AT PRESCRIBED TIMES. DOCUMENTATION WILL BE NEEDED FROM THE REFERRING PROVIDER STATING THAT THE PATIENT HAS BEEN PRE-MEDICATED AND A LIST OF MEDICATIONS PRESCRIBED.

IF THE PT IS OVER THE AGE OF 60, PT IS DIABETIC OR PT HAS KNOWN KIDNEY PROBLEMS THEN THE PATIENTS NEEDS TO HAVE A BUN AND CREATININE BLOOD WORK DONE WITHIN THE LAST 6 WEEKS.

IT IS RECOMMENDED THAT PATIENT'S WHO ARE BREAST FEEDING PUMP AND DUMP FOR 24 HOURS AFTER ANY EXAM WITH CONTRAST. 

CT's and MRI's with contrast

CT and MRI contrast can be performed on the same day, so long as the patient doesn’t screen with any renal issues.   Additionally, only schedule up to 3 CT and/or MRI's with contrast per day.  

 Ideally we should not schedule more than 4 MRI's (without contrast, with contrast or with and without contrast) per day.  Patient has to lay still with no movement.  If there is movement, tech has to start exam over again. 4 exams would have patient laying completely still for 2 hours. 

ANKLE OR FOOT WEIGHT BEARING CT

If you have an order for a weight bearing ankle or foot CT, you should schedule as a PEDCAT.  Please see PEDCAT exam instructions at the bottom of this page. 

CT'S WITH HOYER LIFT - PHOENIX HIGH FIELD OPEN

AS OF 11/20/2023 Hoyer exams will be done on Mondays and Fridays and going forward for ALL modalities from the hours of 8:30am to 4:00pm.  Reminder that these exams must be in an hour long time slot.  If patient has multiple exams, one can be in an hour long time slot and the others can be in 30 minute time slot. Also, please DO NOT book Hoyer's at the same time. (Example: 9am MRI Hoyer and 9am Ultrasound Hoyer) 

We offer a Hoyer lift at Phoenix High Field Open in Phoenix, AZ for patients that need special accommodations to get on the table. 

We must screen the patient to determine the following: Will the patient need the Hoyer Lift and is sitting in a wheelchair, will the patient be coming in on a stretcher, or is the patient coming in a wheelchair BUT can use a slide board.  All patients need to also come in sitting on their sling.  This is VERY important. Stretcher patients DO NOT NEED A SLING.  They will just need to by laying on a blanket or pull sheet (they usually are).

If you have a patient that needs this service, you MUST notate in the patient alerts and the accession. 

Hoyer Lift patients are scheduled Monday and Friday ONLY from 8:30am - 4:00pm due to needing enough staff to help with transferring the patient.  These exam requires 1 hour (60 minutes) for the exam.  If you cannot find a drop down in EXA that indicates Hoyer lift, select the appropriate exam and make sure to change the duration to 1 hour.  If there are multiple exams in the same modality, first exam needs to be schedule for 1 hour and the additional exams need to be scheduled in a 30 minute time slot. 

If the patient has multiple exams but different modalities, please schedule one after another.  Each in an hour to allow time to transfer.  (Example: CT at 10am for an hour long and then Ultrasound at 11am for an hour long). 

Do not schedule at the same time as another Hoyer lift patient.  

If you need help doing this, please reach out to your lead or the lead support chat for assistance. 

CT PROTOCOLS

CTA Coronary Arteries and Cardiac Structure

CTA Cardiac for Pre-EP/Ablation Mapping/Left Atrium Study

Aorta CTA Thoracic w/Additional ECG-gated evaluation of Aortic Root

CCTA

CCTA w/FFR

CCTA w/ Cleerly

CCTA w/ Cleerly NY

HEART CTA & AORTA CTA: 

These exams listed above will need to be transferred to the PSC-CardiologyHunt Group to be scheduled.

You can reach out 2 ways:

Email: PSC-CardiologyHuntGroup@simonmed.com 

Phone: 844-615-2957 (All Calls Warm Transfer...Let the caller know you are transferring to a specialty scheduler to handle their exam needs. If no one is available to the moment they will have an option to leave a voicemail. If voicemail kicks on you can release the caller.)

DO NOT REACH OUT TO BRIANNA RODRIGUEZ, SIRENA CRUZ AND DENISE CORTEZ VIA THEIR DIRECT EXTENSION OR EMAIL.  THE EMAIL AND PHONE NUMBER ABOVE WILL GO TO THEM.

Below are the highlighted exams (in addition to those listed above) you will transfer to this Team, do not move orders to this team unless they are the above or below exams

**CONTRAST IS USED FOR THE ABOVE EXAM**

To find locations that perform and exam below please click on the link for the site search tool below:

Site Search Click Here

CT CYSTOGRAM WITH CONTRAST (6937) 

Check the site search on the portal for facilities that can perform.  (NOTE: Not performed in AZ)

Site Search

CT WHOLE BODY SKELETAL (8501)

CPT: 76497

Oral Contrast: None

IV Contrast: None

Prep: None

• Scan from the vertex of the calvarium inferiorly through the proximal to mid femurs

• Duration 15 minutes

Target Specialty:  Oncology

Indication:  To stage multiple myeloma

• Low dose whole body skeletal CT has been utilized as an alternative to a skeletal survey to assess for lytic lesions in multiple myeloma patients as CT is much more sensitive than plain film. The radiation dose is not much more than a skeletal survey so it is being utilized more.

• This is also being ordered when a patient has had an abnormal skeletal survey and the PET/CT is denied, this exam has been an alternative recommended study from the insurance company

CT Sinus (Fusion/Stealth/3D Render Stealth/Instatrak) Protocol

Drop Down in Exa 

Fusion (6119)

Stealth (7993)

3D Render Stealth (7792)

Instatrak (1310)

Please choose correct sinus protocol type based on order

For locations that can perform please search here.

CT Cardiac Calcium Scoring (460):

• These exams are Self Pay  you will need to schedule and then run Simplicity to get the most up to date self pay rate. Be sure to choose the appropriate region.  (If  patient is electing for us to attempt to process the exam through insurance, we must notate and we must still provide the patient with the cash pay rate so they are aware ahead of time in case insurance denies exam).

• ALL MEDICAID patients must go through insurance. They cannot be offered self-pay.

PLEASE NOTE: In Nevada, Texas and Colorado we DO NOT require orders for this exam.  We DO NEED the name of the patients Doctor so we know where to send their results. 

• We don’t perform cardiac scores for patients with coronary stents or who have had bypass surgery, or if they have a history of atrial fibrillation.

• Can perform on patients with pacemakers

• No caffeine for 6 hours prior

CT Low Dose CT Lung Cancer Screening (6950):

CT Lung Screens must meet the following criteria:

1) Between the ages of 50 and 77 years old 

2) Current smoker or quit within the past 15 years 

3) At least 20 pack year smoking history (# packs per day x years smoking = pack years), **If the patient only smoked ½ pack per day, they would have to smoke for 40 years to be equal to 20 pack years** 

4) No Symptoms such as cough, shortness of breath or chest pain 

ALL CRITERIA MUST BE MET IN ORDER TO SCHEDULE LOW DOSE LUNG CANCER SCREENING

If this is not met, we should offer to schedule and request a new order from the referring Dr for a CT Chest.

Verbiage: "We are calling to request an order revision for your patient, based on our screening done with the patient.  They do not meet the criteria for the Lung Cancer Screening and we are requesting a revised order for a CT Chest to be sent to complete their imaging needs".

We do offer this exam under the Healing Hearts Program in Nevada.   Patient will need to be self pay using the self pay code for Nevada due to the patient self requesting this exam. 

PLEASE NOTE: In Colorado, Nevada and Texas we DO NOT require orders for this exam.  We DO NEED the name of the patients Doctor so we know where to send their results and they must meet the requirements. 

CTA NECK: (ONLY WHEN DR UGLIETTA IS TO READ)

CT ANGIO NECK W/WO CONTRAST W/3D RECON (2850)

CT ANGIO NECK WITH CONTRAST W/ 3D RECON (45)

Needs to have a CTA Head Booked with it.

CT ANGIO HEAD W/WO CONTRAST W/3D RECON (44)

CT ANGIO HEAD WITH CONTRAST W/ 3D RECON (1311)

Not Vice Versa 

CT Pulmonary Veins (7438)  Watchman Protocol

Notate Watchman Protocol in your notes

Can be performed at Paradise Valley, Rome Towers, Mountain View and Thomas in Arizona

Use the locations search on the portal for locations that can perform in other regions

CT BodyCad Protocol (1275) Scanogram

Notate BodyCad in your notes

All sites can perform

CTA Brain Perfusion

Drop Down: CTA Head with and without contrast with perfusion (10015)

Duration: 45 minutes

Only location that performs is Thomas

CT Dual Energy (Ankle/Foot/Hand/Wrist) Gout Protocol

Drop Down in Exa 

Ankle (7811)

Foot (7810)

Hand (7808)

Wrist (7809)

Please choose correct side and body part based on order

CT Upper Extremity (Lima/Smart Space/BluePrint/Materialise) Shoulder Protocol

Drop Down in Exa 

Lima (7799) L/R

Smart Space (7790) L/R

BluePrint (7800) L/R

Materialise (7801) L/R

Please choose correct side and protocol type based on order

For locations that can perform please use the site search here.

CT Extremity Zimmer Protocol (Knee/Shoulder)

Drop Down in Exa

Knee (7425) L/R

Shoulder (7804) L/R

Please choose correct side and body part based on order

CT Blue Ortho Protocol (Shoulder)

Drop Down: CT Shoulder (Please choose correct side based on order)

NOTATE Blue Ortho in scheduling notes

NOT TO BE CONFUSED WITH BLUEPRINT

CT MAKO Protocol

CT Knee Mako (Or) CT Hip Mako

Drop Down:

CT Lower extremity without contrast MAKO HIP (7405)

CT Lower Extremity without contrast MAKO KNEE (7406)

In Exa (Please choose correct side, Right or Left, and Body part based on order)

CT Lower Extremity Prophecy Protocol (Knee/Ankle)

Drop Down in Exa

Knee (7411)  L/R

Ankle (7413) L/R

Please choose correct side and body part based on order

CT Medacta /Conformis Protocol 

All CT scanners except Desert Ridge 

CT Conformis protocol (Hip/Knee)

CT Lower Extremity Conformis Protocol (Hip/Knee)

Drop Down in Exa

Hip (7407) L/R

Knee (7408) L/R

Please choose correct side and body part based on order

CT Lower Extremity (TruMatch/Medacta) Knee Protocol

Drop Down in Exa 

TruMatch (7410) L/R

CT LOWER EXTREMITY WITHOUT CONTRAST TRUMATCH KNEE (LEFT) (7410L)

CT LOWER EXTREMITY WITHOUT CONTRAST TRUMATCH KNEE (RIGHT) (7410R)

Medacta (7418) L/R

CT LOWER EXTREMITY WITHOUT CONTRAST MEDACTA KNEE (LEFT) (7418L)

CT LOWER EXTREMITY WITHOUT CONTRAST MEDACTA KNEE (RIGHT) (7418R)

Please choose correct side and protocol type based on order

CTA CHEST WITH CONTRAST W/3D RECON  (46) AND THE DIAGNOSIS IS FOR PE (Pulmonary Embolism):

NEEDS TO BE SCHEDULED AS STAT. (SAME DAY)

THEY CANNOT BE DONE AFTER 5PM OR ON WEEKENDS

• IF YOU ARE POSTPONING SCHEDULING UNTIL THE NEXT BUSINESS DAY, PLEASE SEND RECAP FORM TO DR'S OFFICE TO MAKE THEM AWARE.  PLEASE DOCUMENT IN SCHEDULING NOTES THAT IT WAS COMPLETED.  IF YOU NEED HELP PLEASE REACH OUT TO LEADERSHIP.

• IF YOU ARE POSTPONING SCHEDULING ON A FRIDAY UNTIL MONDAY, PLEASE SEND RECAP FORM TO DR'S OFFICE AS WELL AS CALL TO MAKE THEM AWARE.   PLEASE DOCUMENT IN SCHEDULING NOTES THAT IT WAS COMPLETED.  IF YOU NEED HELP PLEASE REACH OUT TO LEADERSHIP. 

Low Dose Renal Stone CT 

Available on any CT scanner, this requires Oral Contrast 

Drop Down: Low Dose CT Renal Stone (7687)

Check-in: 45 mins prior

Prep: None 

Duration: 30 minutes

4D CT Parathyroid

Drop Down: CT 4D PARATHYROID WITH AND WITHOUT CONTRAST (601)

All sites can perform

CT VIRTUAL COLONOSCOPY

Medicare Patients over 45 years of age and who have not had a CT Screening in the last 3 years can have a Screening CT Colonoscopy (commion Dx code Z12.11)

Medicare Patients over 45 years of age who are high risk who have not had a CT Screening in the last 2 years can have a Screening CT Colonoscopy.

Individuals with high risk for colorectal cancer means an individual with:

1. A close relative (sibling, parent or child) who has had colorectal cancer or an adenomatous polyp

2. A family history of familial adenomatous polyposis

3. A family history of hereditary nonpolyposis colorectal cancer

4. A personal history of adenomatous polyps; or

5. A personal history of colorectal cancer; or

6. Inflammatory bowel disease, including Crohn's Disease, and ulcerative colitis

Screening Drop Down: Ct Virtual Colonoscopy Screening - (463) 

Some diagnosis are family history of colon cancer, screening for malignant neoplasm of colon.

Diagnostic Drop Down: Ct Virtual Colonoscopy Diagnostic - (640)

Some diagnosis are failed colonoscopy, diverticulosis, incomplete colonoscopy, colonic polyps.

Duration: 45 minutes

Prep: Patient needs to pick a prep kit (Loso Kit and Tagitol Kit) 3 days before the exam from one of our locations that perform Fluoro exams. If the patient does not want to pick up a kit from one of our SimonMed offices they may pick up a bowel cleansing kit from any pharmacy.

PLEASE NOTE: In Colorado we DO NOT require orders for this exam.  We DO NEED the name of the patients                                                                                                                           Doctor so we know where to send their results. 

contrast requirements

IV contrast highlights blood vessels (veins & arteries) as well as major organs such as liver, spleen, pancreas, kidneys, bladder and bowel wall. (Patient's are to be NPO 4 hours prior to exam with IV contrast)

Oral contrast highlights the stomach, small and large bowel. (Patient's MUST check in 45 minutes prior to exam time & NPO 4 hours prior to exam)

CT Abdomen & Pelvis with the following diagnosis:

Require oral contrast 

-         Abdomen Pain

-         Diarrhea

-         Diverticulitis

-         Enterography

-         Hernia

-         Mass (Abdomen or Pelvis)

-         Obstruction

-         Pancreatitis

-         Renal Cancer follow up’s (to look for metastatic disease)

Flank pain will not drink oral

CT Scanogram (1275) – CT Lower Extremity performed for leg length discrepancies

AAA (3806)– CT Abdomen with and without contrast (no oral)

CT Enterography (1286) (yes oral)  Abdo/Pelvis with contrast

Urogram or Pyelogram (625) (No oral) Abdo/Pelvis w/and w/out contrast & IVP **MUST notate urogram or pyelogram 

Kidney Stones (1235) (no oral or contrast) Abdo/Pelvis w/out contrast (Kidney Stone Protocol)

CT Liver (3806) – CT abdomen with and without contrast attention liver (no oral)

Kidney Cyst (607) – CT Abdo/pelvis with and without contrast (no oral)

Lung Screening (6950) – may not be covered by insurance (Run Simplicity)

Hydronephrosis (607)– CT abd/pelvis with and without contrast (no oral) **MUST notate hydronephrosis

CT Venogram (6853) – CT abdomen w/contrast w/3D recon (no oral) **MUST notate venogram 

3 Phase Renal CT (3806) – Abdo w/and w/out contrast (No oral) **MUST notate 3 phase renal

Renal Mass (625) – Abdo/Pelvis w/and w/out contrast & IVP ****MUST notate renal mass

CT PEDCAT SCAN

CT PedCAT 

Drop down in EXA

CT PEDCAT Lower Extremity without contrast (6606)

Please choose correct side based on the order (Left or Right)

Duration: 15 minutes

Only location that can perform is North Gilbert Superstition in the PedCAT Room Monday - Friday 8:30am to 5:00pm