medical imaging troubleshooting guide · processes are bedded in with the ordering clinicians. once...

Medical Imaging Troubleshooting Guide

July 2016

V0.1

Medical Imaging Troubleshooting V1.0 i

Document history

The version history table is useful while the document is in draft. Once the document has been approved, delete all rows except the row with the latest version number (usually 1.00). If an approved document is later updated, update the version history table.

Version Date Status Key changes made Author/s

0.1 05/07/2016 Draft Initial draft Mel Nicolson

0.1 06/07/2016 Draft Review draft Leone Dwyer

1.0 11/07/2016 Final Final Robyn Copley

Contact for enquiries and proposed changes

If you have any questions regarding this document or if you have a suggestion for improvements,

please contact:

Contact Officer Robyn Copley

Title ieMR Digital Release Clinical Engagement Lead

Phone 07 4433 2656

Email [email protected]

mailto:[email protected]

Medical Imaging Troubleshooting V1.0 ii

Document sign off

Approval

The following officer has approved this document

Name: Dr Paul Lane

Position: Clinical Advisor

Signature: Date: 11/07/2016

Name: Robyn Copley

Position: Clinical Engagement Lead

Signature: Date: 11/07/2016

Medical Imaging Troubleshooting V1.0 iii

Contents

1 General ....................................................................................................................... 1

1.1 Are any Requisitions (requests) remaining on Paper? .................................................................. 1

1.2 What is the process for Critical/Urgent Medical Imaging Examinations & Procedures? ............... 2

1.3 What is the process for Theatre (OT) when Medical Imaging is required to attend? .................... 2

1.4 Will there be any changes with Mobile X-rays? ............................................................................. 2

1.5 Afterhours Examination/Procedures, how will they now be managed? ......................................... 2

1.6 How to identify if an order has already been placed for a patient .................................................. 3

1.7 A patient has had an examination recently however it needs to be repeated ............................... 3

1.8 Are there any changes with orders in the Emergency Department? ............................................. 3

1.9 Are Radiology Requisitions printed in Outpatient Clinics? ............................................................. 4

1.10 How will Follow-up Examinations be managed now? .................................................................... 4

1.11 Sending a patient to Private Medical Imaging facility or to another QH Site; can an order be generated in ieMR? ........................................................................................................................ 4

1.12 How to manage orders when a patient is being discharged .......................................................... 4

1.13 Ordering several body regions in one examination, how is that done? ......................................... 5

1.14 What is the difference between Reason for order/details and the Special Instruction field? ......... 5

1.15 Adding a Contact Phone Number .................................................................................................. 5

1.16 Medical Risks and Alerts ................................................................................................................ 5

1.17 eGFR Requirements ...................................................................................................................... 5

1.18 Referring Consultant order entry field ............................................................................................ 6

1.19 There are some orders that require a Consultant signature, how is this now managed? ............. 6

1.20 Ordering PICC’s for insertion Medical Imaging .............................................................................. 6

1.21 A Consent Form and Elective Admission paperwork is normally sent with the paper Medical Imaging request, what happens now? ........................................................................................... 7

1.22 Is it still a requirement to send Specimen Collection Pathology Requests to Medical Imaging for Interventional Procedures? ............................................................................................................ 7

1.23 Will reports feed through to the ieMR? .......................................................................................... 7

1.24 ieMR/QRis Downtime ..................................................................................................................... 7

1.25 Summary Table .............................................................................................................................. 8

2 CT Catalogue Codes (CT) ......................................................................................... 9

2.1 Code Definition ............................................................................................................................... 9

2.2 CT Tips ........................................................................................................................................... 9

2.3 CT Multi Region Codes Examples ............................................................................................... 10

3 X-Ray Catalogue Codes (XR) .................................................................................. 11

3.1 Code Definition ............................................................................................................................. 11

3.2 XR Tips ......................................................................................................................................... 11

3.3 XR Multi Region Codes Examples ............................................................................................... 12

4 MRI Catalogue Codes (MR) ..................................................................................... 13

4.1 Code Definition ............................................................................................................................. 13

4.2 MR helpful hints ........................................................................................................................... 13

4.3 MR Multi Region Code Examples ................................................................................................ 14

5 Theatre Catalogue Codes (II) .................................................................................. 15

Medical Imaging Troubleshooting V1.0 iv

5.1 Common codes ............................................................................................................................ 15

6 Fluoroscopy Catalogue Codes (AF) ....................................................................... 16

6.1 Code Definition ............................................................................................................................. 16

7 Ultrasound Catalogue Codes (US) ......................................................................... 17

7.1 Code Definition ............................................................................................................................. 17

7.2 US Tips ......................................................................................................................................... 17

8 Nuclear Medicine (NM) Catalogue Codes .............................................................. 18

8.1 Code Definition ............................................................................................................................. 18

9 Positron Emission Tomography (PT) Catalogue Codes....................................... 19

9.1 Ordering PET Scans .................................................................................................................... 19

Medical Imaging Troubleshooting V1.0 1

1 General

1.1 Are any Requisitions (requests) remaining on Paper?

All Examinations NOT performed by the Medical Imaging Team will remain on paper. These include:

Vascular Lab (VI)

o VI orders remain in the ieMR orders catalogue, however will not be received by the Townsville Medical Imaging Department. Please ensure these orders are NOT placed in ieMR.

Clinical Measurements

Cardiac Catheter Lab

Cardiac Investigations (CIU)

o Note: - Do not use US Echocardiogram in ieMR.

Respiratory Function Tests (RFTs).

There are some Medical Imaging examinations that are currently outsourced (Mammography (MG) and Bone Mineral Density (BM) which will still need to be entered as an Order in ieMR.

Add Order in ieMR, complete Order Entry Fields, Ensure Paper Order Only ‘No’ is selected. This will ensure the electronic order is still sent to Medical Imaging.

The requisition will need to be printed and signed by the referrer. To Print Requisition, go to Orders Summary Page, right click on Order and select Print Requisition.

o Mammography – Print and give to the patient to take an external Imaging facility

o Bone Mineral Studies – Print and give to the patient to take to Medical Imaging for authorisation if required.

External Imaging Providers and other QH Sites – Orders can still be done in the ieMR. When placing the order, ensure Paper Order Only ‘Yes’ is selected in the Order Entry Field.

Prostate Specific Membrane Antigen (PSMA) – This code is currently unavailable in the ieMR to order the examination electronically. Please use the existing paper Medical Imaging Requisition for PSMA requests. The process will remain the same until the code is available in the ieMR.

MET calls and ED Resuscitation will remain on paper until the ordering processes are bedded in with the ordering Clinicians.

Deceased Examinations will also remain on paper, business as usual.


1.2 What is the process for Critical/Urgent Medical Imaging Examinations & Procedures?

Normal business rules apply for critical scenarios:

Create an electronic order

Contact Medical Imaging Officers in person (as a preference), or by phone

There are ieMR workstations in Medical Imaging Department for referring clinicians to

utilise if required to change an order.

1.3 What is the process for Theatre (OT) when Medical Imaging is required to attend?

Phone call at 30 minutes to notify Radiographer of case

Patient in induction/OT – Doctor enters order on ieMR

Phone call at 10 min call to notify Radiographer to attend OT

For Urgent/unexpected cases – call Radiographer and Doctor enter order into ieMR

Note: - If Radiographer not required for a booked case – please call Medical

Imaging on 31522 to cancel order.

1.4 Will there be any changes with Mobile X-rays?

No. ICU will need to place an Order in ieMR and enter Comment in the Special

Instructions field. ‘7am X-ray Round’

All other mobiles – call Medical Imaging and create Order in ieMR.

Note: - MET calls and ED Resuscitation will remain on paper until the ordering processes are bedded in with the ordering Clinicians.

1.5 Afterhours Examination/Procedures, how will they now be managed?

If the order is generated afterhours and can be performed the following day:

Create order and complete all order entry fields required

Adjust Request start date/time to tomorrows date. Note:- time is not visible in Medical Imaging.

Advise Medical Imaging of when the examination is required by, adding this detail into the Special Instruction field e.g. tomorrow’s date and AM please before OT.

If there is no detail entered in this field it will be processed as a Routine Requisition.

If the examination is Critical/Urgent, follow the current afterhours business rules by contacting the appropriate MID Staff team to arrange in having that examination being performed and reported.


1.6 How to identify if an order has already been placed for a patient

To avoid duplicate orders, please assess any outstanding orders or examinations already

performed through the ieMR Orders Summary Page prior to placing any new orders. If

the status of the Requisition for the patient has changed from routine to urgent/critical,

please contact Medical Imaging rather than create another order.

1.7 A patient has had an examination recently however it needs to be repeated

When placing the new order, use clear Clinical Information in the Reason for

order/details mandatory field to explain reason for requesting an exam that has been

recently performed. This will avoid the exam being declined as it may be viewed as a

duplicate order.

1.8 Are there any changes with orders in the Emergency Department?

Current ordering practices needing approval from the Radiology Registrar will essentially

remain Business As Usual: -

Medical staff to place order and ensure that Consultants name is documented in

the referring Consultant field for all orders placed.

Discuss order with Radiology Registrar either in person as (first preference) or

phone call

If order is approved it will be protocoled by the Radiology Registrar at that time via

IMPAX Protocol.

If, after discussion with the Radiology Registrar, the order needs to be changed to

a different modality this will need to be cancelled and reordered by the ED ordering

Physician.

Once change, call to the Radiology Registrar to Protocol.

Ultrasound – for patient’s returning as Outpatient:-

Place order and change the date to when the patient is to return for the scan

Note in the Special Instruction Order Entry Field write that the patient is returning for USS as outpatient on agreed date (e.g. Tues 21st June),

Contact Radiology Registrar for approval

Attach a patient label for the Emergency Encounter and affix to Medical Imaging patient information slip (patient can call if they don’t hear from Medical Imaging)

Medical Imaging will then contact patient with appointment time

Note: - MET calls and ED Resuscitation will remain on paper until the ordering

processes are bedded in with the ordering Clinicians. Once the order is generated in QRiS

by Medical Imaging, this will be reflected in ieMR on the patients Order Summary page

and results will feed back to the open Emergency Encounter.


1.9 Are Radiology Requisitions printed in Outpatient Clinics?

No. This order will be sent to Medical Imaging electronically. Please send all patients to

the Medical Imaging Department after the clinic appointment to book their

examination/procedure. To assist Medical Imaging staff to locate a patients order:

Attach a patient label for the current Outpatient Encounter and affix to a Medical Imaging patient information slip.

Give to the patient to take to Medical Imaging.

1.10 How will Follow-up Examinations be managed now?

For follow-up examinations, this is highlighted by putting a comment in the Special Instruction field outlining when the examination is required e.g. Follow-up 6/12 or 6 months etc.

1.11 Sending a patient to Private Medical Imaging facility or to another QH Site; can an order be generated in ieMR?

Yes. When placing the order, ensure Paper Order Only ‘Yes’ is selected in the Order Entry

Field. The Radiology Requisition should automatically print to the default printer

associated that workstation. If the Requisition doesn’t print:

Right click on the order(s) from the Order Summary Page

Select print then Print Requisition

NOTE – It is a requirement that all Requisitions that are printed and signed to be

accepted externally.

The order will appear as ‘Paper Order only’ for easy identification and no results will come

back against these orders when sent externally.

1.12 How to manage orders when a patient is being discharged

Radiology orders need to be discontinued or actioned. If the patient intends to use the

Medical Imaging services at TTH after their discharge then:

Attach a patient label for the current Inpatient Encounter and affix to a Medical Imaging patient information slip and give to the patient to take to Medical Imaging

If a patient is to have the examination at a Private Medical Imaging facility or at another QH Site:

Right click on the order(s) from the Order Summary Page

Select print then Print Requisition

If available, select Cancel/Discontinue and enter reason for order being cancelled.

If Cancel/Discontinue is unable to be selected due to Medical Imaging processing the requisition, call Medical Imaging on 31500 to cancel the order.


1.13 Ordering several body regions in one examination, how is that done?

The Radiology Catalogue does have Multi-codes already built into the system. Unlike Pathology where separate orders will populate on the one Requisition, Radiology Examinations, when ordered separately will generate separate orders. This is not ideal as the images need to come back to a single accession number in PACS.

For example, a patient needs a CT Chest, Abdomen and Pelvis. Instead of selecting CT Chest, CT Abdomen, CT Pelvis:

Enter Chest in the Search area and in the search return select CT Chest+Abdomen+Pelvis

There are Multi-codes for most Medical Imaging examinations.

1.14 What is the difference between Reason for order/details and the Special Instruction field?

The Reason for order/detail field is the same as the Clinical History section of the paper request form. All relevant clinical history should be entered into this section.

The Special Instruction field is where any additional information can be written e.g.

Follow-up instructions

1.15 Adding a Contact Phone Number

This is Mandatory. When a contact phone number cannot be provided, type in contact

location in the contact phone number section (character limited) will aid in and order being

actioned and not declined.

1.16 Medical Risks and Alerts

The option to multi-select the Medical risk/alerts order entry field can be done by holding the control or shift key.

If there is more than one Medical risk/alert for XR codes, please include in the Special Instruction field as this function is not currently available.

Note: - Whilst Pregnancy is included in Medical risk/alerts, if the patient is pregnant, please

also include this in the clinical history for the patient in Reason for order/details.

1.17 eGFR Requirements

For all studies involving Intravascular Radiocontrast Agents or MRI contrast, all patients require a risk assessment to minimise the risk of Contrast Media Induced Kidney Injury and Metformin Associated Lactic Acidosis, prior booking their examination. Inclusion of this information will aid the order being actioned and not declined.

Risk Factors include: Known Kidney Disease (Including Kidney Transplant), Diabetes, taking medication containing Metformin.

If the patient has no Risk Factors and has an eGFR result within 6 months record the eGFR result/date in the Special Instruction field.


If the patient does not have an eGFR result within 6 months, place an EUC order, Print and give to the patient.

If the patient has Risk Factors and has an eGFR result within 1 month record the eGFR result/date in the Special Instruction field.

If the patient does not have an eGFR result within 1 month, place an EUC order, Print and give to the patient.

For further details please refer to the RANZCR guidelines Iodinated Contrast Media

Guidelines or contact the Radiologist in Medical Imaging on 33191.

1.18 Referring Consultant order entry field

Completion of this section is required.

When the Referring Consultant is entered in this field, it becomes visible on the Order Summary page in ieMR.

1.19 There are some orders that require a Consultant signature, how is this now managed?

When placing an order that requires a Consultant signature:

All MRI’s must be discussed with the treating consultant before contacting

radiology for approval.

Right click on the order and select Ordering Physician

Change the Ordering Physician to the Consultants in the Physician Name section

Place comment in Special Instruction field ‘ This MRI has been discussed with

Consultant – Dr XXX’

Select Co-Sign Required. This will send a message to the Consultants Message Centre and a co-sign icon will be visible on the Order Summary Page.

Nurse Initiated/per Protocol Orders or other Allied Health Orders will always have a

co-sign prompt where the Consultant needs to be entered in the order, for that the results

to be sent to their message centre for Endorsing.

When placing an order please select Protocol and in the Special Instruction field

document the protocol that it is related to e.g. ‘Nurse Initiated X-Ray (NIXR)’,

‘Midwife Protocol’

Note: If an order is not within a Clinicians scope of practice, it will require a co-sign.

1.20 Ordering PICC’s for insertion Medical Imaging

In the search area enter PICC or AF PICC Insertion. In the Special Instruction field please include and Bleeding Risks and/or Drugs Affecting Coagulation and INR result/date.

Note: - Please do not use US PICC or US PICC Non-Medical Officer codes.


1.21 A Consent Form and Elective Admission paperwork is normally sent with the paper Medical Imaging request, what happens now?

For all procedures where paperwork is sent to Medical Imaging with the request form this

will still need to be bought to Medical Imaging.

Place electronic order

Complete other required paperwork as required e.g. Consent, Elective Admission

form

Send paperwork with the patient to Medical Imaging or deliver to Central Bookings

Medical Imaging.

Please do not send Consents for scanning.

1.22 Is it still a requirement to send Specimen Collection Pathology Requests to Medical Imaging for Interventional Procedures?

Yes. If the ordered procedure requires Specimen Collection e.g. Biopsy/Fine Needle

Aspiration, Lumbar Punctures or Pre Procedural bloods, the Pathology Order needs to be

placed at the same time and given to the patient. This will ensure there are no delays with

scheduling the patient for the Procedure.

1.23 Will reports feed through to the ieMR?

Yes. Once a report has been validated this will be able to be viewed in the Results section of the ieMR. The order will also change to Completed on the order summary page.

Preliminary report can still be accessed through IMPAX or by contacting the Medical

Imaging Reporting Staff to discuss results.

1.24 ieMR/QRis Downtime

Please refer to the ieMR General Business Rules.

Currently there is no Warning/Alert in the ieMR to advise Clinician that QRiS (where

orders are received in Medical Imaging) is down. If your order has not been completed in

a timely manner, please contact Medical Imaging.


1.25 Summary Table

PROCEDURE PROCESS

MRI 1. Discuss with treating consultant

2. Place order in ieMR and comment “this MRI has been

discussed with consultant DR XX” in Special Instruction field

3. Visit Radiology consultant for approval

Mobile X-Rays MET CALL – Phone Radiographer, complete paper request form at bedside

Urgent Mobile on Ward– Place order in ieMR, call radiographer

ICU ward round – place order in ieMR, comment ‘7am round’ in Special Instruction field. For urgent exam, call radiographer

OT Imaging 1. Notify Radiographer minimum of 30 mins notice about case

2. Enter order in ieMR when patient is in Induction bay or on OT

Table

3. Phone Radiographer 10 mins prior to requiring imaging

4. If imaging is not required, call radiographer to cancel order

NOTE: For unexpected cases requiring imaging, call Radiographer to attend OT. MO to place order in ieMR prior to screening.

PICC Lines Exam Code – AF PICC (do not use US codes)

Add eGFR, Coags and bleeding risk to Special Instruction field

Consent, Elective Admission & Path Forms

Complete, send with patient or deliver to MID Central bookings

After Hours

Create order and add detail of when examination is required in Special Instruction field ‘[tomorrows date] and AM before OT’


2 CT Catalogue Codes (CT)

2.1 Code Definition

CODES

CT Chest For tumour or trauma imaging in chest

CT Chest High Resolution For imaging parenchyma of the lungs

CT Kidney+Ureter+Bladder For renal stone diagnosis

CT Lower Extremities Any part of the leg (clinical notes need to indicate which

area of interest)

CT Upper Extremities Any part of the arm (clinical notes need to indicate which

area of interest.

CT Head+Neck Angiogram Head and Carotid Arteries

CT Petrous Bone For IAMs/Mastoids

CT Spine

Cerv+Thor+Lumbosac

For imaging of the full spine in CT

CT Intravenous Pyelogram Multiphase contrast study, usually referred by urology

CT Pulmonary Angiogram For imaging of the pulmonary arteries

2.2 CT Tips

Multiple region codes are listed superior to inferior

Include pelvis for all abdomen imaging

Spine is listed as “CT Spine ….” and then the specific region

There are no specific extremity codes, use the Reason for Order/details field to indicate which part of the extremity selected e.g. CT Upper extremities and CT Lower extremities

Some multi-region codes use ‘abdo’ rather than ‘abdomen’ when search methods is set to ‘Contains’


2.3 CT Multi Region Codes Examples

CT Head+Neck

CT Head+Neck Angiogram

CT Head+Neck+Chest+Abdomen+Pelvis

CT Head+Chest+Abdo+Pelvis

CT Head+Abdomen+Pelvis

CT Neck+Chest+Abdomen+Pelvis

CT Chest+Abdomen+Pelvis

CT Chest+Abdomen+Pelvis Angiogram

CT Abdomen+Pelvis

CT Spine Cervical+Thoracis

CT Spine Cerv+Thor+Lumbosac

CT Spine Thoracic+Lumbosacral


3 X-Ray Catalogue Codes (XR)

3.1 Code Definition

CODES

XR Abdomen Single supine image

XR Abdomen Series Erect Chest and supine Abdomen images

XR Dental OPG Dental investigation

XR Maxillofacial OPG traumatic or # investigation

XR Long Leg Films For weight bearing full length leg with combined multiple

images

XR Leg Whole Usually paediatric imaging when whole leg can be included

on single view

XR Nasogastric Tube

Position

Use XR chest

XR Pelvis and XR Hip Multi-region code should be used e.g. XR Pelvis+Hip

XR PICC Line Check Use XR Chest

XR Scaphoid Use XR Wrist (clinical notes should indicate if scaphoid

views additionally needed)

XR Follow Through For imaging of Small Bowel

3.2 XR Tips

Townsville offers the following mobile imaging:

XR Chest Mobile – All areas

XR Abdomen Mobile – Special Care Nursery only

No need to request multiple areas if they overlap. Humerus is inclusive of the Shoulder and Elbow joints, Femur is inclusive of the Hip and Knee joints etc.

No XR whole spine code exists or multi-region code that covers the Whole Spine in X-Ray

Spine is listed as “XR Spine …..” and then the specific region


3.3 XR Multi Region Codes Examples

XR Wrist+Hand

XR Pelvis+Hip

XR Spine Cervical+Thoracic


4 MRI Catalogue Codes (MR)

4.1 Code Definition

CODES

MR Brain Angiogram Non contrast Circle of Willis add additionally to MR Brain

code if required

MR Bowel Small bowel enteroclysis, small bowel imaging

MR Shoulder Arthrogram Select MR shoulder and indicate in clinical notes if

arthrogram is preferred

MR Perineum For anal fistula

MR Neck For soft tissue imaging of the neck

MR Lower Extremities For imaging of thigh, and tib/fib (clinical notes need to

indicate which area of interest)

MR Upper Extremities For imaging of forearm and humerus (clinical notes need to

indicate which area of interest)

MR Pelvis For general pelvic content imaging

MR Pelvis Female For gynaecological imaging

MR Rectum For rectal Ca imaging

4.2 MR helpful hints

General regions are seldom used, specific organs are imaged in MRI e.g. MR Abdomen is not used rather MR Liver or MR Kidneys

Some MR Brain codes have further definers e.g. epilepsy, multiple sclerosis, spectroscopy, diffusion tensor imaging

MR Brain, MR Brain Angiogram and MR Neck Vessels codes are needed for a full brain MRI and carotid vessel assessment

Spine is listed as “MR Spine …” and then the specific region

MR Spine Whole code is used for Cervical, Thoracic and Lumbar spine imaging

MR Upper/Lower Extremities codes are used for Humerus or Forearm/Femur or Tib Fib. All the joints have individual codes including MR Finger


4.3 MR Multi Region Code Examples

MR Abdomen+Pelvis

MR Abdomen+Pelvis+C

MR Brain+Spine Cervical

MR Brain+Spine Cervical+C

MR Spine Cervical+Brachial Plexus

MR Spine Cervica+Brachial Plexus+C

MR Spine Thoracic+Lumbar

MR Spine Thoracic+Lumbar+C

MR Thoracic + Abdominal Aorta

MR Lumbosacral+C Spine


5 Theatre Catalogue Codes (II)

5.1 Common codes

II External Fixation

II ERCP

II Foreign Body Localisation

II Hip Pinning

II K-Wire

II Manipulation

II Nail

II Operative Cholangiogram

II Open Reduction Internal Fixation

II Retrogram Pyelogram

II Ureteric Stent


6 Fluoroscopy Catalogue Codes (AF)

6.1 Code Definition

CODES

AF Nephrostomy For insertion of Nephrostomy or change of Nephrostomy

AF Gastrostomy Check For review of PEG patency

AF Swallow Radiologist performed assessment of oesophagus. NB this

is not XR Follow Through

AF Video Swallowing

Assess

For speech therapist performed swallowing assessment

AF Pain Block For Joint Injections

AF PICC Insertion For insertion of PICC line in Medical Imaging Department


7 Ultrasound Catalogue Codes (US)

7.1 Code Definition

CODES

US Abdomen For imaging of anatomy or pathology above the belly button

US Pelvis For imaging of anatomy or pathology below the belly button

US Renal Tract Imaging of KUB

US Axilla For imaging the axilla only. US Breast includes all Breast

Tissue and Axilla

US Liver For follow up imaging of the liver only

US Leg Veins … Acute For imaging of DVT

US Neck For general imaging of the neck. Note specific codes exist

for thyroid, salivary glands, carotid arteries

US PICC DO NOT USE US PICC or US PICC Non Medical Officer.

Correct code AF PICC insertion

US Pelvis+Transvaginal Use US Pelvis

US Upper Abdomen Use US Abdomen

7.2 US Tips

After the US Morphology scan has been performed, the code for the second scan in that Trimester is US OB 2nd Trimester.

US OB AFI+Doppler is used for repeat scans in 3rd Trimester to review general foetal health.

Consider the following two or three keywords when looking up US guided intervention. If the correct code cannot be located, please contact the Radiology Registrar on 33191 to confirm the order name required: -

o ‘Biopsy’ - e.g. US FNA

o ‘Procedure’- e.g. US Guided Procedure, US OB Procedure, US Amniocentesis


8 Nuclear Medicine (NM) Catalogue Codes

8.1 Code Definition

CODES

NM Biliary HIDA – Cholecystitis

NM Bone

NM Brain Function Dementia

NM Brain Viability Used by ICU

NM Cardiac Gated Blood

Pool

GBPS, GHPS or MUGA

NM Colonic Transit Replaces Transit Marker studies

NM Gastric Emptying

NM I-123 MIBG

NM In-111 Octreo Diag

NM Lung

Ventilation+Perfusion

VQ Scan

NM Lymph Node Sentinel Prior to Surgery

NM Meckel’s Diverticulum

NM Myocard Perfusion For Ischemia

NM Myocardial Viability For Viability

NM Parathyroid

NM Renal DMSA For scarring and differential function

Nm Renal Dynamic For function, obstruction and differential function – with or without Lasix

NM Renal Pre+Post

Captopril

ACE inhibitor for RAS

NM Therapy I-131

Thyrotoxicosis

Radioactive Iodine

NM Thyroid


9 Positron Emission Tomography (PT) Catalogue Codes

9.1 Ordering PET Scans

When placing an order for PET Scans:

Only use PT Scan code and add detail to the Reason for order/details order entry field to outline Diagnosis, Clinical History and Previous treatment and imaging details.

medical imaging troubleshooting guide · processes are bedded in with the ordering clinicians. once...

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