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X-ray orders

  1. #1
    Question X-ray orders
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    What is acceptable for ordering x-rays? My understanding was the doctor has to request the x-ray be done and even though verbal orders are ok they must be followed up with a written order to support the service.

    In our new urgent care they were operating under standing orders, any trauma they automatically took back to x-ray before the doctor saw the patient. I told them they can't do this the doctor must order it.

    Now, the MA is walking up to the doctor saying "patient is here with a sore ankle, do you want me to do an x-ray?". Does this count as a valid verbal order? This was not doctor initiated in my opinion.

    Any help will be greatly appreciated.


    Laura, CPC, CPMA, CEMC

  2. #2
    North Carolina
    I agree with you...

    D. Diagnostic Tests

    1. Ordering of Diagnostic Tests In our November 22, 1996 final rule for the 1997 physician fee schedule (61 FR 59490), we revised ยง 410.32 (Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions) to state that, to be covered, diagnostic tests had to be ordered by the physician who treats the patient.

    Page 10


    An “order” is a communication from the treating physician/practitioner requesting that a diagnostic test be performed for a beneficiary. The order may conditionally request an additional diagnostic test for a particular beneficiary if the result of the initial diagnostic test ordered yields to a certain value determined by the treating physician/practitioner (e.g., if test X is negative, then perform test Y). An order may be delivered via the following forms of communication:

    A written document signed by the treating physician/practitioner, which is hand-delivered, mailed, or faxed to the testing facility; NOTE: No signature is required on orders for clinical diagnostic tests paid on the basis of the clinical laboratory fee schedule, the physician fee schedule, or for physician pathology services;

    A telephone call by the treating physician/practitioner or his/her office to the testing facility; and
    An electronic mail by the treating physician/practitioner or his/her office to the testing facility.

    If the order is communicated via telephone, both the treating physician/practitioner or his/her office, and the testing facility must document the telephone call in their respective copies of the beneficiary‟s medical records. While a physician order is not required to be signed, the physician must clearly document, in the medical record, his or her intent that the test be performed.
    Last edited by RebeccaWoodward*; 11-23-2010 at 01:29 PM. Reason: ADDED LINKS
    Rebecca CPC, CPMA, CEMC

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