Difficult-to-Order Tests

Fluvid testing

Collected by providers using PPE

Test #520272

Tests for RSV, Influenza A/B, Covid

Mid-turbinate collection:

Colonoscopy

Order "Amb Ref to General Surgery" and write Colonoscopy in the comments

Sleep Study

See the referral guide for details on ordering sleep studies

Lung Cancer Screening

If you have a patient you feel is appropriate for lung cancer screening (USPTF recommendation statement), send a staff message to the RN team or to Bridgette Yeboah-Spaun with your patient's chart attached. You do not need to place an order; this will occur through the process with the RN team and/or Bridgette. 

EKGs

Here is the workflow for EKG ordering, resulting, and billing.

Exercise Stress Tests (Treadmill)

• Order "Graded Exercise Treadmill Test (AKA GXT)" - order number 200104

• Select "Ancillary w/Auth" (w/Auth is required in order to generate a necessary referral in the background) 

• Resulting Agency is "SJH Stress"

• A referral to "AMB Ref to Cardiology" is not required for Stress Tests. 

Physical Therapy

Please write indication for PT in comments section (ex: low back pain, shoulder pain, etc)

GBS 

Order number 516622 

 Penicillin-allergic patient

The SCL lab does NOT have an available order to automatically test sensitivities for PCN-allergic patients who are GBS positive. You must call the lab directly and request that they run sensitivities at the time that you send the sample. The Epic order that pops up for GBS sensitivities does not go to our lab.

Hip ultrasound for newborns (pediatric ultrasound)

The provider needs to place the desired order in Epic, and change the resulting agency to "External." Then, fill out the Children's Hospital Diagnostic Imaging Fax Form - this can be found in each MA station. Then ask the MA to print the order and fax it along with the TCH Diagnostic Imaging Form.

Holter/Event Monitor

Order Amb Ref Cardiology, then type in the comment box “Needs Holter for ____.” Note: Holter monitoring is for up to 48 hours and is continuous. Event monitoring is for up to 30 days and monitors when the patient pushes a button that they are having an event, i.e. syncopal episode. If you also need a cardiologist consult, you need to also specify that separately.

OB

Ultrasound

Dating

• • Order "US Preg 1st trimester (dating)" when you scheduled the patient for dating u/s

  • IMPORTANT: change the resulting agency from Radiant to "External Radiology" so the order can be completed

Anatomy

• • Order "US OB Anatomy Complete"

  • IMPORTANT: change the resulting agency from Radiant to "External Radiology" so the order can be completed

Carrier/cfDNA Screening

OB Info 

Pap Test

First, type Pap, then Amb Pathology Orders.

• For routine pap without STD screening: choose “Cytology Gynecologic”, then under Test, select your desired HPV screen

• For gonorrhea and chlamydia screening: choose “Cytology Gynecologic with Age-Based HPV Screening, Plus CTNG.” CTNG = Chlamydia Trachomatis and Neisseria Gonorrheae.

• For the simple option: choose “Cytology Gynecologic with Age-Based HPV/CTNG.” Samples from patients under 25 will get screened automatically for gonorrhea and chlamydia, and the correct HPV screening will also be done.

If you use any of the above techniques, the correct resulting agency (Ameripath) will already be selected.

Pediatric Imaging (Ultrasounds, XRays)

The provider needs to place the desired order in Epic, and change the resulting agency to "External." Then, fill out the Children's Hospital Diagnostic Imaging Fax Form - this can be found in each nurse's station as well as on the wall near the bullpen Keurig machine. Then ask the MA to print the order and fax it along with the TCH Diagnostic Imaging Form.

Pediatric Echocardiogram (TTE)

If you only need an echo and not a cardiology consultation:

• • Place an order in Epic for Echocardiogram - Pediatric (TTE), order # 20066

  • Your MA will call central scheduling to get this scheduled for the patient

If you need a cardiologist consultation as well as the echo: 

• • Order Amb Ref to Pediatric Cardiology, and specify Echo and consultation in the comments

  • Currently this process is backed up at least 6 months

If you need an urgent consult or urgent echo:

• • Order the above referral as urgent/ STAT and talk to Tammy or Iris in person

  • You can also call Children's One Call (720-777-1234) and speak with the on-call cardiologist about your concern

PFTs (formal)

Place the order in Epic using order # 200008, Complete PFT

REQUIRED: enter info in the comments section letting them know the reason for PFTs. The order cannot be processed without this information. Your MAs must fax the order at the time of visit to the hospital in order to have this scheduled.

Provider-collected cultures

STI Testing

• BFM offers the following tests

• urine GC/CT

• vaginitis panel (Aptima multi test)

• Aptima multi test (gc/ct swab for oropharyngeal and rectal testing and urethral testing in males)

• You can also continue to run GC/CT and vaginitis testing off of pap samples.

HSV

• • Use green top culture tube

  • Send to SCL Health Lab

Wound Culture

• • Use red top swab (same as GBS swab)

  • Send to SCL Health Lab

Throat culture

• • Use red top swab (same as GBS swab)

  • Send to SCL Health Lab

GBS

• • Use red top swab

  • Send to SCL Health Lab

  • See above for sensitivity testing - must call lab to request

GC/CT Throat/rectal swab

• • LABEL EACH TUBE: source, time collected, your initials

  • Use red top tubes and call lab directly to order them. No current good order system in Epic.

Semen analysis

Patients can get semen analysis done through the "Colorado Center for Reproductive Medicine." They do semen analysis for our patients. 

Fill out the information listed, check Semen Analysis and give this paper prescription to your patient. They will pay out of pocket, ~$175-200, if they are uninsured or their insurace does not cover the cost.

You should receive a faxed sheet with the results.