Radiology Orders

Create radiology orders for tests performed in office or referred to an external radiology facility. Facilities and facility providers are set up in Administration: Facilities. You can set up custom panels for radiology orders in Administration: Radiology or while creating the order (see Create a Custom Panel).

Navigate to Radiology Orders

Do one of the following:

• In the encounter, click P on the SOAP menu, select Orders, and then select New Radiology.
• In the chart, click the Orders tab and then click Radiology.

Create a Radiology Order

The Order Date and Order Time is set to the current date and time. The Due Date depends on the Urgency Criteria (one week from current date for Routine and one day for Stat or Call).

1. Select the Appt Date and Appt Time.

2. Confirm the Ordering Provider and Location.
3. Select how the patient is notified of the appointment (if you selected an appointment date and time).
4. Click the Urgency Criteria.
5. Select the Diagnosis Code.

In-office Radiology Order

In-office radiology orders are performed at the ordering location.

6. Select the In-Office check box.
7. In the Test/Consult Type section, select the procedure code from the panels to be used for billing. If the test requires AUC consultation, AUC Required  appears next to the test name. For instructions, see Consult AUC.

8. Click Create Order & Result.

External Facility Radiology Order

6. Select the Facility and the Provider (if available).
7. In the Test/Consult Type section, select the procedure code from the panels to be used for billing. If the test requires AUC consultation, AUC Required  appears next to the test name. For instructions, see Consult AUC.
8. Click Create Order.

9. Print or fax the order to the external facility.

Consult AUC

For information on the AUC Program, refer to the Appropriate Use Criteria (AUC) Program FAQ. For additional information and workflows, see notes or additional workflows.

Required: You must be in an encounter.

7. In the Test/Consult Type section, select the procedure code from the panels to be used for billing.
8. Select the check boxes for the tests and click Consult AUC.

The AUC Consultation confirmation window opens.

9. Click Proceed.

The CareSelect Imaging application opens.

10. Below Select an Indication Based on Diagnosis, select the reason for the test based on the patient's diagnosis. If no options are available (because the diagnosis is not appropriate for the test), search for the patient's diagnosis or symptoms and select an option below.

11. View the test's appropriateness for the patient and confirm or replace the test. Requested and appropriate exams show either below or to the right.

The CareSelect application provides the appropriateness rating for the test ordered and includes alternative tests and their respective rating. The requested test shows below Requested Exam and appropriate tests with higher ratings show below Appropriate Exams.

Rating scale: 1-3: usually not appropriate, 4-6: may be appropriate, 7-9: usually appropriate

Confirm the requested test

1. Click Confirm & Order.
2. If the requested test has a rating of 3 or lower, select the reason and click Submit. Comments are optional.

Replace the requested test with a more appropriate test

1. Click Replace & Order.

To view the American College of Radiology appropriateness criteria for this clinical condition, click View Evidence for Exams at the top of the window. You can download a PDF of the report.

In our example, there is an MRI that is more appropriate for our patient. We select 70551 with the higher rating by clicking Replace & Order.

 - Cost
 - Relative Radiation Level (RRL)

Since the appropriate test is the same as the second test we selected on the Order Radiology page, we cancel the second test. When the application window closes, the test is no longer selected.

The CareSelect application closes. The AUC Consultation Completed window opens that shows the tests you ordered before AUC consultation and the ones you selected after consultation. Click OK.

AUC Completed shows next to the tests indicating that AUC consultation has been completed.

In our example, since we canceled the second test (because it is the same as the one we replaced our first selected test with), we will remove the test that still has next to its name before creating the order (select the test and click Remove Test). 

12. Click Create Order (for external facility) or Create Order & Result (for in-office).

After you create the order, shows on the Orders page below Options. You can edit orders in Orders (O > Order Results) or Order History (O > Order History).

Additional Workflows

Cancel the Test

1. Do one of the following:

• Click Cancel at the top of the window.

• If you are viewing the appropriateness section, click Cancel Order.

2. Click Yes, Cancel.

Exit the CareSelect Imaging application

1. Click the x in the upper right corner.
2. Click Yes.

Copy as New

You can copy an order as new in Orders (O > Order Results) or Order History (O > Order History).

1. Select the test's row.
2. Click Copy as New.

The Order Radiology page opens. The test has next to its name. The AUC Completed status does not carry over to the new order.

Notes

• Tests without appropriate exam recommendations: If you select the most appropriate test for the patient based on the diagnosis, you do not receive recommendations for more appropriate exams. The AUC Consultation Completed window will open showing the same test listed before and after AUC consultation. The test will have next to its name on the Order Radiology page. In our example, if we had selected only 70551 and performed AUC consultation, the consultation would process, the AUC Consultation Completed window would open, and we would be back on the Order Radiology page with next to 70551.
• Unmapped tests: There are few tests that cannot be mapped to the CareSelect Imaging application so these unmapped tests do not show on the CareSelect Imaging application. The tests show on the AUC Consultation Completed window and on the Order Radiology page with next to their test names.
• Diagnosis coding is required to consult AUC.
• No more than six tests can be selected at a time for AUC consultation.
• You may get the same appropriate test recommendation for multiple requested tests. If you notice that you replaced the same test for multiple tests, make sure you delete duplicate tests before creating the order. 

Create a Custom Panel

We recommend that you save a group of tests as a custom panel for faster charting in the future. After you select the procedure code (step 7 above), the test/procedure appears below Custom Panels. You can also set up custom panels in Administration: Radiology.

1. Select the check boxes of the tests/procedures you want to add to the custom panel.
2. Click New Custom Panel.
3. Type a New Custom Panel Name.
4. Click Create Order (external facility) or Create Order & Result (in-office).