Get the free Coronary CTA Referral Form - The Queen's Health Systems
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Coronary CTA Referral Form1301 Punchbowl Street Honolulu, Hawaii 96813 Phone (808) 6917171 Fax (808) 6917007 ___ Do you authorize the use of FFRCT as medically indicated? Yes No Scheduling Information
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What is coronary cta referral form?
The coronary CTA referral form is a document used by healthcare providers to authorize and outline the need for a coronary CT angiography procedure, which is a non-invasive imaging test to assess coronary artery conditions.
Who is required to file coronary cta referral form?
Healthcare providers or specialists who are requesting a coronary CT angiography for a patient are required to file the coronary CTA referral form.
How to fill out coronary cta referral form?
To fill out the coronary CTA referral form, a healthcare provider must provide patient information, relevant medical history, clinical indications for the test, and any pertinent insurance information.
What is the purpose of coronary cta referral form?
The purpose of the coronary CTA referral form is to ensure that the appropriate medical justification is documented for conducting a coronary CT angiography and to facilitate communication between healthcare providers and imaging centers.
What information must be reported on coronary cta referral form?
The information that must be reported includes patient demographics, clinical history, symptoms, prior relevant tests, and the reason for the referral.
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