Wiki Radiology Order

[Ldari]

I am questioning if an order is valid for Radiology. Is it acceptable to only have the diagnosis code present? At a previous facility it was required to be written out but I'm not sure if that was a policy or true requirement. Thanks in advance for your help.

 

[Pam Warren]

We prefer the written diagnosis; that way a coder could append the correct numeric code. But what's happened recently is that in the process of getting pre-certifications for certain radiological procedures, the diag code is required because our pre-cert staff are not coders. Both are ok, as long as the order is signed and dated, and most EHRs are now printing orders with the code right on there.