Patients calling in about x-ray should be asked what location they wish to go to for their exam so that we can provide them with the hours the site is open, as well as confirmation the site performs the exam.  X-rays are done on a walk-in basis. Make sure it is not a Fluoro Exam and does not include IV contrast or barium. If patient insists on having an appointment, schedule & let the patient know there may be a wait and they may not be seen at their appointment time depending on the current wait time.

Verbiage “ X-rays are done on a walk in basis, if you can provide me with the site you wish to go to I can ensure they perform the exam and give you the hours.”

Once the site is shared, you should look on the locations list on the portal (https://portal.simonmed.com/location/) to validate they can execute the exam and then provide hours.  The hours are on the left per modality. (See image below)

**Please note that some of our smaller regions do need appointments for X-ray's, that is why it is very important you check the locations list so that you can validate what is the proper and accurate steps to take with your callers.

For Example: In Kentucky, currently X-rays are NOT walk in.  They MUST be scheduled.

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 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.

NON Weight Bearing All States - This is for Ankle and Foot X-rays ONLY!

sitz marker study

Sitz marker studies need to be scheduled as: 

CR ABDOMEN SITZ COLON TRANSIT INITIAL-9003

CR ABDOMEN SITZ COLON TRANSIT RETURN-9004

This will give you a total of 2 accessions

You will need to notify the patient of the return and note you advised them

These can be done at any location in the x-ray room

Check in for initial will be 30 minutes prior, document this was told to the patient

Days to Schedule

Monday Initial and Friday Return

Wednesday Initial and Tuesday Return

Can Schedule initials on Tuesday and Thursday but patient must be returning to a site open on the weekends. 

x-ray IVP  (NoT performing at this time)

INTRAVENOUS PYELOGRAM 

· IVP (561)

 IVP’s, also known as Intravenous Pyelogram, is an x-ray test that provides pictures of the kidneys, the bladder, the ureters, and the urethra (urinary tract). An IVP can show the size, shape, and position of the urinary tract, and it can evaluate the collecting system inside the kidneys.

During the IVP, a dye called contrast material is injected into a vein in your arm. A series of X-ray pictures will be taken at timed intervals.

IVP is commonly done to identify diseases of the urinary tract, such as kidney stones, tumors, or infection.

The contrast used for this procedure is Iodine based so please ask the patient CT screening questions. We need to know if the patient is allergic to iodine. These are scheduled for 1 hour. (4 Blocks)

Check site search on portal for locations that perform.

**WE DO NOT DO IVP WITH TOMO** 

Prep instructions: PATIENT MUST PICK UP A PREP KIT AT SIMONMED AT LEAST 3 DAYS PRIOR TO APPOINMENT. HAVE PATIENT FOLLOW DIRECTIONS FOR BARIUM ENEMA PREP KIT. PATIENT MUST HAVE NOTHING TO EAT OR DRINK 4 HOURS PRIOR TO THE EXAM. IF NEEDED PATIENT MAY TAKE MEDICATION WITH A SMALL AMOUNT OF WATER AT LEAST 4 HOURS PRIOR TO THE EXAM. 

PLEASE ASK PATIENT IF THEY ARE ALLERGIC TO IODINE. IF THEY ARE PATIENT WILL NEED TO BE PRE-MEDICATED.

PRE-MEDICATION REGIMAN 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, DIABETIC OR HAS KNOWN KIDNEY PROBLEMS THEN THE PATIENTS NEEDS TO HAVE A BUN AND CREATININE DONE WITHIN THE LAST 6 WEEKS.

Profile Spine x-ray statera spine

PROFILE CERVICAL AND PROFILE LUMBAR

· PROFILE CERVICAL (7773)

· PROFILE LUMBAR (7774)

This is an x-ray with a special protocol for Lumbar and cervical spine x-rays. These will be ordered as Profile Lumbar or Profile Cervical X-rays.

These must be scheduled at a facility that has the software to connect with Statera Spine that will generate a Profile report.

Bone age/bone survey x-rays

BONE AGE STUDY

· BONE AGE STUDY (505)

Bone Age X-ray are done

·        For the hands

·        Done on walk in basis 

·        Normally done on children

·        Any Location can do these

BONE SURVEY

· BONE SURVEY COMPLETE (508)

Bone Survey/Skeletal Survey are the same

·        Most sites can do this.  Please call site to make sure.

·        It is preferred to be done on Digital x-ray since its faster

·        It can be scheduled since it takes an hour long but can still be done on a walk in basis.

baby hips

6 months and older. If the child is younger than 6 months we need to do a baby hip ultrasound.

SCOLIOSIS 36' STANDING XRAY

Can be performed at Dobson Village and Fashion Square