Wiki oncology question

KGibbar

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Can an oncologist order a low dose CT scan for a patient currently under her care? She has been told in the past that only a PCP can order and be paid for this. This seems odd to me because the results of the scan determine the course of care for her. Ultimately she would be treating him and managing his care if the results show recurrence or there are issues to be addressed.
 
I'm a little confused by the "only a PCP can order and be paid for this." Only the radiologist/facility gets paid for the CT scan.
Typically the ordering physician can be anyone involved in the patient's care, not just the PCP. I've worked in gynonc for 15+ years, and have never had an issue ordering a test. There have been instances where we cannot get authorization for the test without the involvement of PCP, but that happens in the rare instance that we are not in network, and received an out of network auth for the visit.
Who is telling you the specialist cannot order the test??
 
^^ This.

If it's a PPO, your MD can order it. If it's an HMO, then it's up to the HMO's rules, but I don't know of any HMO's that wouldn't allow that.
 
I'm a little confused by the "only a PCP can order and be paid for this." Only the radiologist/facility gets paid for the CT scan.
Typically the ordering physician can be anyone involved in the patient's care, not just the PCP. I've worked in gynonc for 15+ years, and have never had an issue ordering a test. There have been instances where we cannot get authorization for the test without the involvement of PCP, but that happens in the rare instance that we are not in network, and received an out of network auth for the visit.
Who is telling you the specialist cannot order the test??
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The provider was told this by a colleague. I found it odd as well. Maybe as Sharon stated in her reply, it was a situation of working with an HMO. I appreciate your feedback.
 
OOOHHH, locker room doctor talk. That has lead to many coding mistakes and issues over the years.
I tell my clinicians it's the equivalent of me telling my doctor to change my medications because my neighbor (the plumber) suggested it. :)
 
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