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Thread: referring/ordering tests

  1. #1
    Join Date
    Apr 2007
    Kalamazoo MI

    Default referring/ordering tests

    AAPC: Back to School
    This really does not pertain to coding but kind of does in a round about way. One of my providers stopped and asked if there was anything in writing that states a referring provider must order or complete tests (MRI,CT,BX) prior to a pt being referred to our facility. His reasoning is Dr. X suspects pt has cancer but does not do any test to support that dx, is it then my provider's responsibility to order then needed tests? In this case I'm sure my provider would order the needed tests, prior to pt being seen, so he has some clinical information to base his visit on besides the primary's assumption.

  2. #2


    you can refer to Medicare manual for ordering of diagnostic tests. 1/11/08 CMS issued transmittal 80. Medicare benefit policy manual, Chapter 15.
    These guidelines are also posted in the Medlearn reference book CT/MR Coder 2009.
    I hope this helps
    Susan Carter CPC
    Associates in Radiology of Plattsburgh NY PC

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