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)
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 exams, these cannot be done after 5pm or on weekends.
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.
WEEK OF 9/2 TO 9/6
AZ Tech Capabilities
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.
**DO NOT PERFORM STRESS TEST AT ANY SMI LOCATION**
ABDOMEN ULTRASOUND
ABDOMEN COMP (416)
If order is for gallbladder, it would be abdomen limited (1280)
US ABDOMEN COMP W/UDFF (10131)
US ABDOMEN LIMITED W/UDFF (10132)
30 MINUTES (2 Blocks)
NOTHING TO EAT OR DRINK AFTER MIDNIGHT
MUST BE SCHEDULED IN THE MORNING (NO LATER THAN 10:30 AM) DUE TO NATURAL GASES BUILD UP IN THE STOMACH THAT CAN CREATE FALSE READINGS.
IF YOU ARE BOOKING A PELVIC AND ABDOMEN ULTRASOUND, ALWAYS SCHEDULE THE PELVIC FIRST AND YES PT STILL NEEDS TO BE NPO EXCEPT FOR THE WATER PREP (32 oz and hold). Book Pelvic, then Abdomen directly after and let them know to drink their water 1 hour before both exams. After their pelvic exam they will be allowed to use the restroom
*IF YOU ARE BOOKING A NUCMED EXAM WITH THIS PLEASE ALWAYS SCHED THE U/S FIRST.
ABDOMEN DUPLEX
DUPLEX SCAN ABD/PELV/RETROPER (453)
MAY ALSO BE CALLED LIVER DUPLEX OR LIVER DOPPLER
60 MINUTES (30 MINUTES FOR THE ABDOMEN U/S THAT HAS TO BE SCHEDULED ALONG WITH IT) TOTALING 90 MINUTES( 6 Blocks)
NEEDS TO BE SCHEDULED WITH AN ABDOMEN ULTRASOUND -MUST BE SCHEDULED IN THE AM (NO LATER THAN 10:30AM)
PREP PATIENTS SHOULD DRINK PLENTY OF WATER THE DAY BEFORE THEIR EXAMS SO THAT THEY ARE WELL HYDRATED MAKING THE VESSELS BETTER VISUALIZED / NOTHING TO EAT OR DRINK AFTER MIDNIGHT
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
ABDOMEN ELASTOGRAPHY (Mercy Care/Mercy Care Advantage: US (Elastrography) cpt 76981 is a 14 day minimum TAT)
ABDOMEN LIMITED WITH ELASTOGRAPHY (6869) OR IF FOCUS IS ON LIVER USE ABDOMEN COMPLETE WITH LIVER ELASTOGRAPHY (6806)
US ABDOMEN LIMITED WITH ELASTOGRAPHY W/UDFF (10130) OR US ABDOMEN COMPLETE WITH ELASTOGRAPHY W/UDFF (10129)
MAY ALSO BE CALLED FIBROSCAN
IF FOCUSED ON LIVER PLEASE USE ABDOMEN COMPLETE WITH LIVER ELASTOGRAPHY
COMPLETE 60 MINUTES (4 Blocks) | LIMITED 45 MINUTES (3 Blocks)
MUST BE SCHEDULED IN THE AM (NO LATER THAN 10:30AM)
NOTHING TO EAT OR DRINK AFTER MIDNIGHT. NO SMOKING, CHEWING GUM, OR CANDY
SITES THAT CAN PERFORM W/UDFF: APACHE JUNCTION, MOUNTAIN VIEW AND LITCHFIELD
ARTERIAL DOPPLER (Health Choice/Health Choice Generations: DUPLEX/DOPPLER is 5-7 day minimum TAT)
DUPLEX SCAN ARTERY LEG/GRAFT BIL (2847) FOR BILATERAL
DUPLEX SCAN ARTERY LEG UNI OR LT (448) FOR UNILATERAL MAKE SURE TO CHOOSE RIGHT OR LEFT
BILATERAL 60 MINUTES (4 Blocks), UNILATERAL 30 MINUTES(2 Blocks)
PLEASE MAKE SURE TO NOTE IF UPPER OR LOWER AND CHECK TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR
PREP PATIENTS SHOULD DRINK PLENTY OF WATER THE DAY BEFORE THEIR EXAMS SO THAT THEY ARE WELL HYDRATED MAKING THE VESSELS BETTER VISUALIZED
PLEASE MAKE SURE TO CHECK THE SITES BANNERS AND SCHEDULING BLOCKS TO ENSURE IT CAN BE DONE AND ARE AT THE RIGHT TIME AND ROOM
ABI ONLY (ANKLE BRACHIAL INDEX)
ABI COMPLETE (6936) FOR BILATERAL
ABI LIMITED (7686) FOR UNILATERAL MAKE SURE TO CHOOSE RIGHT OR LEFT
BILATERAL 30 MINUTES (2 Blocks) UNILATERAL 30 MINUTES (2 Blocks)
WE DO NOT HAVE TO BOOK AN ARTERIAL DOPPLER IF ABI ONLY IS BEING ORDERED.
PLEASE MAKE SURE TO NOTE IF UPPER OR LOWER AND CHECK TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR
PREP PATIENTS SHOULD DRINK PLENTY OF WATER THE DAY BEFORE THEIR EXAMS SO THAT THEY ARE WELL HYDRATED MAKING THE VESSELS BETTER VISUALIZED. PLEASE HAVE PATIENT WEAR LOOSE FITTING PANTS OR SHORTS
WE DO NOT DO ABI WITH EXERCISE/STRESS
PLEASE MAKE SURE TO CHECK THE SITES BANNERS AND SCHEDULING BLOCKS TO ENSURE IT CAN BE DONE AND ARE AT THE RIGHT TIME AND ROOM
AORTA
ABDOMINAL AORTA LIMITED (422)
MAY ALSO BE CALLED AAA OR AORTA U/S OR ABDOMEN AORTA U/S
SCHED FOR 30 MINUTES (2 Blocks)
NOTHING TO EAT OR DRINK AFTER MIDNIGHT
MUST BE SCHEDULED IN THE MORNING (NO LATER THAN 10:30AM) DUE TO NATURAL GASES BUILD UP IN THE STOMACH THAT CAN CREATE FALSE READINGS.
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
BPP BIOPHYSICAL PROFILE
BIOPHYSICAL PROFILE (1146)
WILL BE ORDERED AS THIS NO OTHER NAMES
SCHED FOR 30 MINUTES (2 Blocks)
NO PREP
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
BREAST
US-BREAST BILAT COMPLETE (6365) FOR BILATERAL.
US-BREAST UNILAT COMPLETE (RIGHT)(6252) | (LEFT)(6361) FOR UNILATERAL MAKE SURE TO CHOOSE LEFT OR RIGHT
SCHED FOR 30 MINUTES (2 Blocks)
NO PREP
PLEASE REFER TO THE SCHEDULING BLOCKS AT THE SITE YOU ARE SCHEDULING FOR AND KEEP IN MIND A RAD HAS TO BE PRESENT SO THESE CANNOT BE DONE TOO EARLY OR TOO LATE
PLEASE MAKE SURE TO CHECK THE SITES SCHEDULING BLOCKS TO ENSURE THEY ARE AT THE RIGHT TIME AND CORRECT ROOM
SECOND LOOK BREAST
SHOULD BE HANDLED BY THE WOMENS CARE COORDINATOR***** Transfer to WCC Queue
BREAST-BILATERAL IN RIS PULL DOWN FOR BILATERAL
BREAST-UNILATERAL IN RIS PULL DOWN FOR UNILATERAL MAKE SURE TO CHOOSE LEFT OR RIGHT
SCHED FOR 30 MINUTES (2 Blocks)
NO PREP
THESE ARE RECOMMENDED AFTER A DIAGNOSTIC/ULTRASOUND OR BREAST MRI HAS ALREADY BEEN DONE
THESE MUST BE BOOKED AT THE SITE WHERE THE READING RAD WILL BE WHO ORIGINALLY READ THE DIAGNOSTIC/ULTRASOUND OR BREAST MRI
PLEASE MAKE SURE TO CHECK THE SITES BANNERS AND SCHEDULING BLOCKS TO ENSURE THEY ARE AT THE RIGHT TIME AND CORRECT ROOM
PLEASE REFER TO THE BANNERS AND SCHEDULE BLOCKS AT THE SITE YOU ARE SCHEDULING FOR AND KEEP IN MIND A RAD HAS TO BE PRESENT SO THESE CANNOT BE DONE TOO EARLY OR TOO LATE.
BREAST BIOPSIES/AXILLA LYMPH NODE BIOPSIES
ALL BREAST AND AXILLA LYMPH NODE BIOPSIES ARE TO BE HANDLED BY THE WOMAN'S CARE COORDINATORS ONLY!!!!!!
Transfer to WCC Queue
CAROTID
DUPLEX SCAN CAROTID BIL; COMP (417)
SCHED FOR 30 MINUTES (2 Blocks)
PREP PATIENTS SHOULD DRINK PLENTY OF WATER THE DAY BEFORE THEIR EXAMS SO THAT THEY ARE WELL HYDRATED MAKING THE VESSELS BETTER VISUALIZED
PLEASE MAKE SURE TO CHECK THE SITES BANNERS AND SCHEDULING BLOCKS TO ENSURE THEY ARE AT THE RIGHT TIME AND CORRECT ROOM
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
CAROTID WITH INTIMA-MEDIA THICKNESS
CAROTID COMPLETE WITH CIMT (7563)
SCHED FOR 30 MINUTES (2 Blocks)
PREP: NONE
THIS IS A SELF PAY EXAM. INSURANCE DOES NOT COVER CIMT. RUN SIMPLICITY FOR MOST UP TO DATE PRICING.
CERVICAL LYMPH NODE MAPPING
CERVICAL LYMPH NODE MAPPING (7465)
SCHED FOR 30 MINUTES (2 Blocks)
PREP NONE
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
INFANT HIPS
INFANT HIPS, DYNAMIC (438)
SCHED FOR 30 MINUTES (2 Blocks)
BABY HAS TO BE 5 WEEKS OF AGE IF PREGNANCY WENT FULL TERM (40 WEEKS), IF BABY WAS BORN EARLIER THAN 40 WEEKS EACH WEEK EARLY NEEDS TO BE ADDED TO AGE. I.E.BABY WAS BORN AT 37 WEEKS, THEN WE ADD 3 WEEKS TO THE 5 WEEK AGE AND BABY SHOULD BE AT 8 WEEKS TO HAVE THE PROCEDURE DONE. YOUR NOTES MUST INDICATE AT WHAT WEEK MOTHER WAS AT WHEN CHILD WAS BORN.
OLDEST IS 6 MONTHS IF OLDER THAN 6 MONTHS NEEDS TO BE SCHEDULED FOR HIP XRAY.
THESE EXAMS ARE SPECIALIZED ONLY SPECIFIC TECHS AT CERTAIN SITES CAN PERFORM. A CALL NEEDS TO BE MADE TO THE SITE/ PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
INFANT PYLORUS
PYLORUS (INFANT) (1264)
MAY ALSO BE CALLED PYLORIC STENOSIS
MUST BE A STAT EXAM
Order does not have to say STAT but still MUST be scheduled as STAT
THIS EXAM WILL BE WORDED AS PYLORIC STENOSIS OR WILL BE USED WITH PROJECTILE VOMITING AND ABDOMEN ULTRASOUND FOR AGE 2 WEEKS TO 2 ½ MONTHS. IF OLDER THAN 2 ½ MONTHS WE RECOMMEND UGI.
PREP NOTHING BY MOUTH AT LEAST 1 HOUR PRIOR. PARENT SHOULD BRING A BABY BOTTLE WITH CLEAR FLUID (PEDIALYTE), AND A NIPPLE TO BE GIVEN TO THE INFANT DURING THE EXAM NOT BEFORE. PARENTS CAN BRING FORMULA TO THE APPT BUT CANNOT GIVE TO THE BABY UNTIL AFTER EXAM IS COMPLETE.
THESE EXAMS ARE SPECIALIZED ONLY SPECIFIC TECHS AT CERTAIN SITES CAN PERFORM. A CALL NEEDS TO BE MADE TO THE SITE
INFANT SPINES
SPINAL CANAL AND CONTENTS (424)
SCHED FOR 30 MINUTES (2 Blocks)
CAN BE DONE 0-6 mo for both male and female
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
MESENTERIC ARTERIES (Duplex SMA Exam)
US DUPLEX SCAN SUPERIOR MESENTERIC ARTERY/CELIAC ARTERY (9064)
SCHED FOR 60 MINUTES (4 Blocks)
NPO AFTER MIDNIGHT
NEEDS TO BE SCHEDULED BEFORE 10:30AM
PATIENT IS TO BRING A BOTTLE OF ENSURE (ANY FLAVOR) TO THE EXAM
PREP PATIENTS SHOULD DRINK PLENTY OF WATER THE DAY BEFORE THEIR EXAMS SO THAT THEY ARE WELL HYDRATED MAKING THE VESSELS BETTER VISUALIZED
NOTES SHOULD SPECIFICALLY STATE “MESENTERIC ARTERY”, “SMA”, OR “CELIAC AXIS”
NON VASCULAR
US EXTREMITY NON VASCULAR; COMPLETE (5297)
SCHED FOR 30 MINUTES (2 Blocks)
NO PREP
MAKE SURE TO PUT THE DX AND WHAT PART OF THE BODY IN THE NOTES FOR THE APPT
OB ULTRASOUND (Health Choice/Health Choice Generations: OB US is 5-7 days TAT)
ALWAYS HAVE TO NOTE HOW MANY WEEKS PREGNANT THE PT IS
IF IT IS <14 WEEKS (0-14 WEEKS) OB LESS THAN 14 WKS; SINGL/1ST GESTATN W/TV (7473)
SCHED FOR 30 MINUTES (2 Blocks)
IF IT IS >14 WEEKS (14+ WEEKS) OB GREATER THAN 14WKS; SINGL/1ST GESTATN, (427)
SCHED FOR 60 MINUTES (4 Blocks)
OB LESS THAN 14 WEEKS; MULT GESTATN W/TV (7472) IN PULL DOWN IF TWINS THEN EXAM IS AN HOUR; MAKE SURE TO ADD EACH ADDTL GESTATION
OB GREATER THAN 14 WEEKS; MULT GESTATN (428) IN PULL DOWN IF TWINS THEN EXAM IS AN HOUR; MAKE SURE TO ADD EACH ADDTL GESTATION
PREP 14 WEEKS OR LESS 32 OZ OF WATER AND HOLD BLADDER NEEDS TO BE FINISHED 1 HOUR PRIOR TO EXAM TIME.
15-30 WEEKS 16 OZ OF WATER AND HOLD BLADDER NEEDS TO BE FINISHED ONE HOUR PRIOR TO EXAM TIME.
31 WEEKS AND UP NO PREP
WE DO NOT HAVE OB VIEWING MONITORS OR THE ABILITY TO DO OB 3D
PLEASE MAKE SURE TO CHECK THE SITES BANNERS AND SCHEDULING BLOCKS TO ENSURE THEY ARE AT THE RIGHT TIME AND CORRECT ROOM
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
*If an OB patient is requiring an OB Anatomy scan then the preferred gestational age at minimum is 18 weeks per our Radiologists. If the exam is ordered for size/dates only then we can scan at any gestational age. OB Anatomy scans are 1 hour in length to document all anatomy of the fetus thoroughly best seen at 18-24 weeks gestational age.
PELVIC
PELVIC (NON OB) COMPLETE TA/TV WITH DUPLEX IMAGING (1290)
SCHED FOR 30 MINUTES (2 Blocks)
PREP DRINK 32 OZ OF WATER AND HOLD BLADDER NEEDS TO BE FINISHED ONE HOUR PRIOR TO EXAM TIME.
YOU CAN SCHED A PELVIC WITH NO TRANSVAG IN CASES OF PATIENTS UNDER 18 OR IF THE DOCTOR SPECIFICALLY ASKS. Use PELVIC (NON OB) COMPLETE WITH DUPLEX IMAGING (433)
Male patients - US Pelvic Male (Non GYN) (7025)
IF YOU ARE BOOKING A PELVIC AND ABDOMEN ULTRASOUND ALWAYS SCHED THE PELVIC PRIOR TO THE ABDOMEN. HAVE THE PT DRINK 32 OZ OF WATER 1 HOUR PRIOR TO LEAVING TO APPOINTMENT AND HOLD THE BLADDER.
PLEASE MAKE SURE TO CHECK THE SITES BANNERS AND SCHEDULING BLOCKS TO ENSURE THEY ARE AT THE RIGHT TIME AND CORRECT ROOM
PROSTATE
PELVIC IN PULL DOWN IF ORDER READS TA PROSTATE U/S ONLY OR IF IT IS A MEDICARE PT WITHOUT TRANSRECTAL SPECIFICALLY ON ORDER NOTE ACCOUNT TRANSABDOMINAL PROSTATE ONLY
TRANSRECTAL (436) IF NOT MEDICARE AND IF ORDER STATES PROSTATE U/S
SCHED FOR 30 MINUTES (2 Blocks)
PREP USE ONE FLEETS ENEMA ONE HOUR PRIOR TO YOUR EXAM. THIS CAN BE PICKED UP AT ANY LOCAL PHARMACY.
WHEN SCHEDULING THESE PLEASE NOT ONLY CHECK TECH LIST AND TECH SCHEDULE BUT ALSO MAKE SURE THE SITE HAS THE PROBE AVAILABLE FOR THIS EXAM.
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
RENAL
RENAL (RETROPERITONEAL) COMPLETE (579)
MAY ALSO BE ORDERED AS KIDNEY U/S
SCHED FOR 30 MINUTES (2 Blocks)
PREP PT DRINKS 32 OZ OF WATER AND HOLDS BLADDER NEEDS TO BE FINISHED ONE HOUR PRIOR TO EXAM TIME. CHILDREN 12 AND UNDER DRINK 16OZ OF WATER AND HOLD, IF PT IS UNABLE TO HOLD HAVE THEM RELEASE BUT THEN STILL CONTINUE TO DRINK WATER UP TO THE APPT.
IF BOOKING WITH A RENAL DOPPLER YOU CAN SCHEDULE IN ANY ORDER BACK TO BACK. PATIENT WILL NEED TO BE NPO EXCEPT FOR WATER PREP IF RENAL WITH BLADDER
RENAL ARTERY DOPPLER (Health Choice/Health Choice Generations: DUPLEX/DOPPLER is 5-7 day minimum TAT)
RENAL ARTERY DOPPLER (1062)
MAY ALSO BE CALLED OR ORDERED AS RENAL W DUPLEX OR RENAL ARTERIES
SCHED FOR 60 MINUTES (4 Blocks)
NEEDS TO BE IN AM (NO LATER THAN 10:30AM)
PREP NOTHING BY MOUTH AFTER MIDNIGHT, NO FOOD OR DRINK SCHEDULE ONLY IN THE MORNING. THEY SHOULD DRINK PLENTY OF WATER THE DAY BEFORE THE EXAM TO HELP WITH THE STUDY.
IF BOOKING WITH A RENAL WITH BLADDER: YOU NEED TO SCHEDULE RENAL WITH BLADDER FIRST . PATIENT WILL NEED TO BE NPO EXCEPT FOR WATER PREP
PLEASE MAKE SURE TO CHECK THE SITES BANNERS AND SCHEDULING BLOCKS TO ENSURE THEY ARE AT THE RIGHT TIME AND CORRECT ROOM
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
PENILE ULTRASOUND
WE CANNOT DO THIS EXAM
TRANSPLANTED KIDNEY
RENAL TRANSPLANT COMPLETE W/DUPLEX IMAGING (423)
SCHED FOR 60 MINUTES (4 Blocks)
NO PREP UNLESS BLADDER IS REQUESTED TO BE INCLUDED THEN PT NEEDS TO DO WATER PREP
PLEASE MAKE SURE TO CHECK THE SITES BANNERS AND SCHEDULING BLOCKS TO ENSURE THEY ARE AT THE RIGHT TIME AND CORRECT ROOM
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
TESTICULAR
TESTICULAR WITH DOPPLER (435)
SCHED FOR 30 MINUTES (2 Blocks)
NO PREP
PLEASE MAKE SURE TO CHECK THE SITES BANNERS AND SCHEDULING BLOCKS TO ENSURE THEY ARE AT THE RIGHT TIME AND CORRECT ROOM
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
THORACIC OUTLET
THORACIC OUTLET (1059)
SCHED FOR 30 MINUTES (2 Blocks)
SCHED AN UPPER ARTERIAL RIGHT AFTER FOR 60 MINUTES (4 Blocks)
DUPLEX SCAN ARTERY ARM (449)
TOTAL EXAM TIME WITH BOTH SHOULD EQUAL 90 MINUTES (6 Blocks)
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
THYROID
HEAD/NECK/THYROID/PARATHYROID (419)
SCHED FOR 15 MINUTES (1 Block)
NO PREP
IF YOU ARE BOOKING A NUCMED EXAM WITH THIS PLEASE ALWAYS SCHED THE U/S FIRST.
PLEASE MAKE SURE TO CHECK THE SITES BANNERS AND SCHEDULING BLOCKS TO ENSURE THEY ARE AT THE RIGHT TIME AND CORRECT ROOM
Thyroid Biopsy (Fine Needle Aspiration/FNA) scheduling
Apart from conventional radiology, SimonMed Imaging is able to provide an interventional radiology procedure known as a fine needle aspiration (thyroid biopsy). This mildly invasive, in-office procedure can be done at certain locations, which offers a more cost-effective procedure combined with optimal imaging we are known for.
Prep:
· Prior imaging MUST be on file prior to exam. (please reference how to request medical records if the patient has outside prior imaging that is needed to be sent to us). Not having prior images and reports will lead to a delay in patient care and prompt a reschedule.
· Patients HAVE TO discontinue the use of blood thinning medication such as Coumadin/Plavix/NSAIDS/Xarelto, ect. 5 days prior to the procedure. If these are prescribed, the PT must speak with their physician and obtain instructions and a clearance note to discontinue them. This note must be hand carried to the appointment. If they are unable to hold the meds, the procedure must be approved by the performing radiologist.
FAQs
· Patient may take Tylenol for pain prior to exam, if desired. (not to supplement Ibuprofen/Advil in place of Tylenol as the instructions currently say Ibuprofen should be avoided as above)
· Patient will receive a local anesthetic to numb the area being biopsied
· Technologist and radiologist will go over aftercare with the patient at appointment time
· Results from the biopsy generally take 5-7 days for processing due to pathology. These results will go directly to the ordering provider who will provide results to the patient
· If the order/prior report mentions there are more than one nodule needing to be biopsied, a separate accession will need to be created. ( example: 2 nodules= 2 accessions/2 hours’ time needed) We should not schedule more than two nodules in a day.
NOTE for Florida ONLY: If a patient does not have prior imaging completed at SimonMed Imaging, a consult needs to be scheduled first. This placeholder can be booked on any day, and then canceled. The dropdown for this is ‘Consult on outside images’. Priors MUST be requested or patient advised to bring in the priors so our radiologists can review the images and confirm if the biopsy is needed. Once the records have been received, attached to the accession and reviewed by the radiologist, the patient can be scheduled. This process can take approximately 1-2 weeks depending on turnaround time on the records request. If the radiologist determines the biopsy is not needed, we will not perform. Make sure to notate the accession with the ticket number provided by the medical records service desk upon ticket submission.
The drop downs used to schedule these procedures are:
· Code 1200 THYROID FINE NEEDLE ASPIRATION/BIOPSY
o to be used for the first nodule/only nodule
· Code 9043 THYROID FINE NEEDLE ASPIRATION/BIOPSY;EACH ADD’L LESION
o To be used as the additional nodule being scheduled, when applicable
Things to remember:
· ALWAYS reference the previous report on file. This report must be no older than 3 months (90 days) old. If we do not have prior imaging, or imaging that is older than 3 months old, the patient will need to speak to their physician to obtain a thyroid ultrasound order
· ALWAYS request prior imaging if we do not have any on file
· ALWAYS follow color blocks placed on the schedule/shown in find slots
· ALWAYS use the locations search on the portal to find locations that can perform
· If ever in doubt, please reach out. Your team lead, lead support chat or site manager will always be willing to assist. WE want to make you successful!
THYROID BIOPSY
THYROID FINE NEEDLE ASPIRATION (1200) / BIOPSY
To be used for the first nodule/only nodule
Code 9043 THYROID FINE NEEDLE ASPIRATION/BIOPSY;EACH ADD’L LESION
To be used as the additional nodule being scheduled, when applicable
SCHED FOR 60 MINUTES FOR EACH NODULE (4 Blocks)
IF BILATERAL OR ORDER STATES LEFT AND RIGHT WE NEED TWO ACCESSIONS ONE FOR EACH SIDE
READ FULL PRIOR REPORT EACH NODULE NEEDS ITS OWN TIME FRAME
PREP: Patients HAVE TO discontinue the use of blood thinning medication such as Coumadin/Plavix/NSAIDS/Xarelto, ect. 5 days prior to the procedure. If these are prescribed, the PT must speak with their physician and obtain instructions and a clearance note to discontinue them. This note must be hand carried to the appointment. If they are unable to hold the meds, the procedure must be approved by the performing radiologist.
PRIOR U/S (SOMETIMES CT) NEEDED FOR COMPARISON
MUST NOTE PATHOLOGY COMPANY TO BE SENT TO DEPENDING ON INSURANCE. THIS NEEDS TO BE NOTED IN ALL CAPS IN CLINICAL INFO (PLEASE SEE IMAGE BELOW)
IF YOU ARE BOOKING THE PATIENT FOR THE SAME WEEK OR THE NEXT WEEK PLEASE ASK THE PATIENT IF THEY CAN ASSIST IN OBTAINING THEIR PRIOR EXAMS. THIS WILL HELP ENSURE THEIR EXAM IS NOT DELAYED. WE ALSO NEED TO REQUEST PRIOR IMAGING. WE NEED REPORTS AND CD’S OR FILMS.
DOCUMENT PATIENT WAS INFORMED TO BRING IN PRIORS AS WELL AS YOUR Medical Records Request TICKET NUMBER.
CALIFORNIA THYROID BIOPSY
THYROID FINE NEEDLE ASPIRATION (1200) /BIOPSY
To be used for the first nodule/only nodule
Code 9043 THYROID FINE NEEDLE ASPIRATION/BIOPSY;EACH ADD’L LESION
To be used as the additional nodule being scheduled, when applicable
SCHED FOR 60 MINUTES (4 Blocks)
IF BILATERAL OR ORDER STATES LEFT AND RIGHT WE NEED TWO ACCESSIONS ONE FOR EACH SIDE
READ FULL PRIOR REPORT EACH NODULE NEEDS ITS OWN TIME FRAME
PREP: 5 DAYS NO BLOOD THINNERS HAS TO BE APPROVED BY THE PRESCRIBING DOCTOR. PLAVIX IS A THINNER.
PRIOR U/S (SOMETIMES CT) NEEDED FOR COMPARISON
MUST HAVE PRIOR US AT SIMONMED TO SCHEDULE
IF PRIOR US WAS PERFORMED OUTSIDE OF SIMONMED MUST BE WITHIN 3 MONTHS
DR FRIED WANTS TO REVIEW AND APPROVE BEFORE EXAM CAN BE SCHEDULED
FLORIDA THYROID BIOPSY
THYROID FINE NEEDLE ASPIRATION (1200) /BIOPSY
To be used for the first nodule/only nodule
Code 9043 THYROID FINE NEEDLE ASPIRATION/BIOPSY;EACH ADD’L LESION
To be used as the additional nodule being scheduled, when applicable
Make sure to prep the patient:
No dietary restrictions (Pt does not need to be fasting).
Go over any meds the patient may be taking.
Height & weight
Allergies (latex/lidocaine)
Areas of the biopsy must be free of any hair to avoid infection (should be clean shaved).
**Results take an average of 3-5 business days. Patients referring MD will be the one to contact the patient with the results**
Important information regarding medication
It is important that the patient does not take any of the following medications 5 full days before their procedure and 24 to 48 hours after their procedure.
Aspirin Plaquenil** Any NSAID Ibuprofen Ecotrin Vitamin E Coumadin
Advil Clinoril Warfarin** Naprosyn Voltaren Lovenox Indocin
Vioxx Palvix Pletal Alka Seltzer Xarelto Relatin Asacol
Motrin Bextra Arthrotec Aleve Celebrex Fish Oil Omega 3
*If the patient is taking Coumadin (Warfarin), they will need permission from their physician to discontinue it for a minimum of 2 days prior to their biopsy. They will also need to have a PT/INR blood test (Promthrombin).
Please advise the patient to bring the written results for the radiologist to review. Need INR to be less than 1.5
VENOUS INSUFFICIENCYS
DUPLEX SCAN VENOUS INSUFFICIENCY BILATERAL (1347) IF BILATERAL
DUPLEX SCAN VENOUS INSUFFICIENCY UNILATERAL (1349) IF UNILATERAL MAKE SURE TO CHOOSE LEFT OR RIGHT
SCHED FOR 90 MINUTES BILATERAL (6 Blocks) 45 MINUTES UNILATERAL (3 Blocks)
ASK PATIENTS IF THEY CAN STAND UNASSISTED FOR EXTENDED PERIODS OF TIME,
BETWEEN 20-40 MINUTES?
PREP PATIENTS SHOULD DRINK PLENTY OF WATER THE DAY BEFORE THEIR EXAMS SO THAT THEY ARE WELL HYDRATED MAKING THE VESSELS BETTER VISUALIZED
DIAGNOSIS INCLUDE VARICOSE VEINS, VENOUS INSUFFICIENCY, VEIN MAPPING, SKIN DISCOLORATION, ROPY VEINS, ACHING OR BURNING SENSATION IN LEGS AND FEET, CRAMPING REFLUX/EVAL REFLUX AND LEG WEAKNESS
THIS EXAM IS VERY SPECIFIC AND WE HAVE TO MAKE SURE THE TECH/SITE CAN DO IT PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR
VENOUS DOPPLER (Health Choice/Health Choice Generations: DUPLEX/DOPPLER is 5-7 day minimum TAT)
US DUPLEX SCAN LOWER EXTREM VEINS; BILATERAL (2369)
US DUPLEX SCAN LOWER EXTREM VEINS; UNILATERAL (LEFT) (5824)
US DUPLEX SCAN LOWER EXTREM VEINS; UNILATERAL (RIGHT) (5824)
US DUPLEX SCAN UPPER EXTREM VEINS BILATERAL (1604)
US DUPLEX SCAN UPPER EXTREM VEINS; UNILATERAL (LEFT) (5536)
US DUPLEX SCAN UPPER EXTREM VEINS; UNILATERAL (RIGHT) (5536)
MAKE SURE TO CHOOSE LEFT OR RIGHT
SCHED FOR 60 MINUTES BILATERAL (4 Blocks) 30 MINUTES UNILATERAL (2 Blocks)
PREP PATIENTS SHOULD DRINK PLENTY OF WATER THE DAY BEFORE THEIR EXAMS SO THAT THEY ARE WELL HYDRATED MAKING THE VESSELS BETTER VISUALIZED
ALWAYS SCHED THESE EXAMS AS A STAT AS PER SIMONMED PROTOCOL (no matter the diagnosis)
Order does not have to say STAT but still MUST be scheduled as STAT
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.
SOME DIAGNOSIS INCLUDE DEEP VEIN THROMBOSIS (DVT, BLOOD CLOT), PAIN IN LEGS, EDEMA OR SWELLING IN LEGS
CANNOT BE SCHEDULED IN BLOCKS THAT STATE “NO VASCULAR STUDIES”
PLEASE MAKE SURE TO CHECK THE SITES BANNERS AND SCHEDULING BLOCKS TO ENSURE THEY ARE AT THE RIGHT TIME AND CORRECT ROOM
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
HEMODIALYSIS GRAPHING
(This is for evaluation for pre op to graft)
DUPLEX SCAN VENOUS INSUFFICIENCY BILATERAL (1347)
SCHED FOR 60 MINUTES
AS WELL AS DUPLEX SCAN ARTER LEG/GRAFT BILAT (447)
SCHEDULE FOR 90 MINUTES
TOTAL EXAM TIME IS 150 MINUTES (11 Blocks)
PREP PATIENTS SHOULD DRINK PLENTY OF WATER THE DAY BEFORE THEIR EXAMS SO THAT THEY ARE WELL HYDRATED MAKING THE VESSELS BETTER VISUALIZED
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
HEMODIALYSIS ACCESS
(This is for evaluation for an existing graph)
DUPLEX SCAN OF HEMODIALYSIS ACCESS (459)
SCHED FOR 90 MINUTES (6 Blocks)
PREP PATIENTS SHOULD DRINK PLENTY OF WATER THE DAY BEFORE THEIR EXAMS SO THAT THEY ARE WELL HYDRATED MAKING THE VESSELS BETTER VISUALIZED
PLEASE SEE TECH LIST/SCHEDULE TO ENSURE THE SITE CAN DO THE EXAM ON THE DAY YOU ARE SCHEDULING FOR.
WE ARE PERFORMING MSK ULTRASOUNDS AT THE CENTRAL PHOENIX LOCATION ON FRIDAY'S IN ULTRASOUND ROOM 3 AND WITH TECH MAURINE MILLER.
PLEASE CHECK FOR BLOCKS AND THE US TECH SCHEDULE.
WE ARE LIMITED WITH THE NUMBER OF APPOINTMENT SLOTS AVAILABLE AND ARE ONLY AFFORDED 5 MSK SLOTS PER WEEK.
PLEASE ENSURE THAT IF YOU ARE ASSISTING WITH SCHEDULING AN MSK ULTRASOUND, IT IS INDEED FOR MUSCULOSKELETAL PURPOSE AND NOT FOR SOFT TISSUE ASSESMENTS.
MUSCULAR SKELETAL ULTRASOUNDS (MSK) MUST NOTATE THE BODY PART IN SCHEDULING NOTES
Physicians will send their patients over with vague orders, that sometimes provide little information on what it is they want to have done, but they will usually leave some identifying factors such as- shoulder pain, knee pain, elbow pain, etc. This usually helps at least narrow down what kind of study is to be performed.
For most MSK studies, the ICD 10 code M13.80 can be used since it lists Other-Arthritis which can be an issue that is usually seen in all areas described below.
Please note that if an order comes across stating (Bilateral) anywhere within the order it will need to be scheduled as two separate studies, each for 30 mins. This is also for billing purposes since multiple sites are being assessed.
Do not schedule for MSK if the order is for soft tissue of:
Mass/Lump in Axilla (this is done by breast U/S) male and female
Chest mass/lump if close to breast tissue (this is done by breast U/S) male and female
Mass/Lump on thyroid (should be thyroid U/S)
Mass/Lump on neck (possibly a lymph node mapping or thyroid U/S)
Unclear orders for leg pain need to be verified not for LEV exam, for example
RT leg ultrasound for RT leg pain
OK to schedule for MSK:
The basic categories of MSK, along with the usually attached ICD 10 codes are:
Shoulders.
(M25.51. Shoulder pain, M75.21. Bicipital tendonitis, Biceps tear) Not limited to.
Elbows
(M25.52. Elbow pain. M25.522. Rt or Lt elbow pain) Not limited to.
Wrists
(M25.53. Wrist pain. M25.531 ganglion cysts, arthritis, Median nerve of wrist ok ok, No radial nerve or ulnar nerve studies, Rt or Lt wrist pain) Not limited to.
Hands
Finger pain, arthritis, strain/sprain, NO finger pulleys or nerves of fingers
Knees.
(M25.569. Pain in either knee) Not limited to.
LIMITED hip studies- For fluid / bursitis ONLY.
(M25.55. Hip pain)
Foot/Feet
Morton's Neuroma, Plantar fascia, Fibroma's, Ganglion cysts, Arthritis
Ankle studies
(M25.57. Ankle pain. M76.6 Achilles pain) Full ankle exams, Achilles tendon, arthritis
Calf/Gastrocnemius for tears in calf muscle
DO NOT schedule for MSK if it says rule out DVT. This would be an venous doppler exam
ALL PLEASE SEE BELOW THE RULES WHEN DEALING WITH AN MSK U/S.
MSK EXTREMITY ( NON VASCULAR ) IN PULLDOWN (6130)
An accession is needed for each body part (MUST NOTATE THE BODY PART IN SCHEDULING NOTES)
ULTRASOUND CAN BE PERFORMED ON:
SOME GUIDELINES TO FOLLOW:
SHOULDER- RTC Tears, INCLUDING SNAPPING BICEP OR TENDON TEARS AT THE SHOULDER
SUBLUXATION (DISLOCATION OR STRUCTURAL DISPLACEMENT) EXAMPLE, ULNAR NERVE AT ELBOW
PALPABLE ABNORMALITY/SWELLING
LUMP/LIPOMA
BURSITIS
GANGLION
CYST
BAKERS CYST/KNEE
HERNIA
MUSCLE TEAR/SPRAIN/RUPTURE
HIPS: U/S CAN BE USED FOR LOOKING FOR JOINT FLUID/BURSITIS OR FLUID COLLECTION AROUND THE HIP. EXAMPLE: R/O ILIOPSOAS OR TROCHANTERIC BURSITIS. PATIENT HEIGHT AND WEIGHT MUST BE OBTAINED. BODY HABITUS CAN LIMIT VISIBILITY.
ACHILLES TENDON TEAR/TENDONITIS
ELBOW: TENNIS ELBOW (LATERAL EPICONDYLITIS), PITCHERS ELBOW (MEDIAL EPICONDYLITIS), ULNAR NERVE DISLOCATION, OLECRANON BURSITIS/ KNEE FOR BURSITIS/TENDONITIS/TENDINOPATHY
Hands/Wrists- Rheumatology
Feet- R/O Neuromas, Plantar fascia, Fibromatoma, Rheumatology
Ankles- Tendon tears
Wrists- Ganglions, tenosynovitis
Ulnar/ median and radial nerves- Neuropathy
Calf muscles- Gastrocnemius tears
MRI IS PREFERRED WHEN WE ARE LOOKING AT:
INGUINAL OR GROIN STRAIN OR HIP PAIN ON A LARGER BODY HABITUS
LABRUM OF HIP
HAMSTRINGS (U/S IS NON DIAGNOSTIC FOR PROXIMAL HAMSTRING TENDON TEAR DUE TO DEEP LOCATION
KNEE (U/S DOES NOT ADEQUATELY EVALUATE MENSCI, ACL, PCL, AND ARTICULAR CARTILAGE) GET MRI OR CT ARTHOGRAM
NON VASCULAR CAN BE PERFORMED:
PALPABLE ABNORMALITY
LUMP
GANGLION
CYST
BAKERS CYST
FOREIGN BODY
HYSTEROSONOGRAMS (NOT PERFORMING AT THIS TIME AT ANY SIMONMED LOCATION)
HYSTEROSONOGRAM (592)
SCHED FOR 60 MINUTES 4 Blocks
DR. CLARE COLUMBO IS THE ONLY RADIOLOGIST THAT DOES THIS EXAM
THESE EXAMS REQUIRE A RECENT PELVIC US WITHIN THE LAST 2-3 MONTHS, PRIOR TO APPOINTMENT.
IF PELVIC US NEEDS TO BE SCHEDULED, IT NEEDS TO BE ON A DIFFERENT DAY.
RAD (DR COLOMBO) NEEDS TO BE ONSITE FOR SALINE INJECTION
DO NOT SCHED SAME TIME AS A BX, OR HSG
THIS EXAM CAN BE DONE ANY TIME OF THE MONTH AS LONG AS THE PT. IS NOT CURRENTLY BLEEDING
PT CANNOT BE SEEN IF ACTIVELY BLEEDING OR SPOTTING
NO PREP
************THIS EXAM IS NOT FOR INFERTILITY ************
US Echocardiogram with Strain, 3D Echo and Contrast (10150)
US Echocardiogram with Strain and 3D Echo (10151)
Prep: Avoid caffeine day of exam
Location that performs: Dobson 1 on Monday and Wednesdays Only
Procedure Drop Down: Echocardiogram w & w/o Doppler TTE (1398)
Duration: 60 Minutes
Prep: None
For Pediatric Echos:
Patients who are 15 years of age can have an echo done. Patients who are 14 and younger, may be done with clearance from Echo Lead Trevor Squibb.
This exam can be done in other states besides AZ, but only can be read by Dr. Michael Illovsky.
Agents should always refer to the US tech capabilities provided in the KB and review banner.
If an agent schedules an Echo for a patient between the age of 15 to 18 they will need to give their lead the accession.
The lead will then need to email Trevor Squibb with info.