Get the free IMAGING CENTER PHYSICIAN'S ORDER FORM

2929 Napoleon Avenue New Orleans, LA 70115 Phone: 504-897-8600 Fax: 504-897-8589 www.touro.com/imaging IMAGING CENTER PHYSICIAN S ORDER FORM PATIENT NAME D.O.B. DATE DIAGNOSIS CODE (ICD-9) (REQUIRED)

How to fill out imaging center physician39s order

How to fill out imaging center physician's order:

1. Obtain the required form: Contact the imaging center or check their website to find out if they provide an online form or if you need to obtain a physical copy from them.
2. Fill in patient information: Provide the patient's full name, date of birth, address, and contact information. Make sure all the details are accurate and up to date.
3. Complete the referring physician information: Enter the name, contact information, and any other required details of the referring physician who ordered the imaging.
4. Specify the imaging study: Clearly indicate the type of imaging test or study that needs to be performed. This could include X-rays, CT scans, MRIs, ultrasounds, etc.
5. Provide clinical information: Include relevant medical details that may assist the radiologist in interpreting the images. This may involve describing the patient's symptoms, relevant medical history, and any specific concerns or areas of interest.
6. Indicate the urgency: If the imaging study is time-sensitive or requires immediate attention, clearly mark it as urgent. Otherwise, specify the desired timeframe for the study to be conducted.
7. Obtain necessary authorizations: If required by your healthcare provider, get the appropriate signatures and authorizations on the form. This could include the patient's signature, referring physician's signature, or any other required individuals.

Who needs imaging center physician's order:

1. Patients requiring diagnostic tests: Individuals who require imaging tests for diagnostic purposes, such as those experiencing symptoms that warrant further investigation or follow-up.
2. Individuals referred by healthcare professionals: Patients who have been referred by their primary care physicians, specialists, or other healthcare providers for diagnostic imaging studies.
3. Insurance purposes: In some cases, insurance companies may require a physician's order for certain imaging studies to approve coverage and reimbursement.
4. Research or clinical trials: Patients participating in research studies or clinical trials may also require a physician's order for imaging tests as part of their study protocol.

Overall, anyone who needs an imaging study for medical evaluation or treatment purposes will typically require a physician's order from a healthcare provider.

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What is imaging center physician's order?

An imaging center physician's order is a formal request by a physician for a patient to undergo a medical imaging procedure, such as an X-ray, MRI, or CT scan, to assist in diagnosis or treatment planning.

Who is required to file imaging center physician's order?

The prescribing physician who determines the need for imaging is required to file the imaging center physician's order.

How to fill out imaging center physician's order?

To fill out an imaging center physician's order, the physician must provide patient information, specify the type of imaging requested, detail the clinical indications, and include any relevant medical history or instructions.

What is the purpose of imaging center physician's order?

The purpose of an imaging center physician's order is to ensure that appropriate imaging studies are conducted based on clinical needs, to facilitate proper diagnosis, and to maintain a clear record for both medical providers and patients.

What information must be reported on imaging center physician's order?

The information that must be reported on an imaging center physician's order includes patient demographics (name, date of birth), ordering physician details, the type of imaging needed, clinical indication for the exam, and any relevant medical history or previous imaging results.