# X-ray orders



## LLovett (Nov 23, 2010)

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.

Thanks

Laura, CPC, CPMA, CEMC


----------



## RebeccaWoodward* (Nov 23, 2010)

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 § 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.

http://www.gpo.gov/fdsys/pkg/FR-1997-10-31/pdf/97-28973.pdf

Page 10

Also...
*Order*

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*.


https://www.cms.gov/manuals/Downloads/bp102c15.pdf


----------

