Diagnosis Requirement for Radiology Orders Physician Education Effective March 25 th , 2015: Diagnosis will be required when placing ALL Radiology orders both Inpatient and Outpatient. When giving radiology orders via phone or verbal, a nurse will prompt for a diagnosis. Diagnosis Control Problem/Diagnosis control will be available in the orders window. All admit plans WILL require an actual diagnosis in the request bed order and will populate the diagnosis control. If an appropriate diagnosis exists, click the check box and continue placing the radiology order/powerplan. Select only the applicable diagnosis for the radiology order. 2/2015 (AKC) 1 Add Diagnosis to Visit/Radiology Order Option 1 – *Must enter prior to placing order 1. Begin typing a generic description in the “IMO” search field of the Diagnosis control within the orders window and hit enter. The “Add” button may also be used, but the search option directly in the control is more efficient. 2. A diagnosis search box is presented to provide further specificity of diagnosis. Select the description that best matches the provided diagnosis for the radiology procedure. 3. Ensure the diagnosis is viewable in the DX control and verify that the check box is selected. Continue placing your order or powerplan with included radiology order. Option 2 – *Add diagnosis once the order has been added to the order scratch pad 1. Within the radiology order details including radiology orders within powerplans, there is a required “Diagnosis” tab. Click this tab. 2/2015 (AKC) 2 2. Select the “Add” button and enter the description that best matches the provided diagnosis for the radiology procedure. Do not modify any additional fields. 3. Adding the diagnosis completes the required field for this order. Continue placing your order/powerplan. Below you will note that the previously required “Reason for Exam” field is no longer required. Remove Diagnosis *This should only be done, when diagnosis is added incorrectly. 1. Right click on the diagnosis within the control and select “Remove Diagnosis”. The diagnosis will still be a part of the patients chart but will be inactive. 2/2015 (AKC) 3 Converting a Problem to Diagnosis *Patient problems should be provider managed. Any problem can be quickly converted to a visit diagnosis as shown below 2/2015 (AKC) 4
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