A patient presents for a screening mammogram without an order, and the history sheet indicates no signs or symptoms but a history of breast cancer five years ago. Our facility protocol is for a diagnostic mammogram up to and including the fifth year for patients with a breast cancer diagnosis. Do we need to get an order from the patient’s doctor, or can we just do the diagnostic exam?
You cannot do a diagnostic mammogram without an order. Your protocol does not/cannot over-ride that. In a hospital, your radiologist could write the order (at least for Medicare patients), but it would have to be an individual order for an individual patient, and not a standing order for any patient. In imaging centers, you would have to have an order from the patient’s treating physician.
If you do get a new order and perform a diagnostic mammogram, you would need to make sure that the patient understands that she would now be responsible for her co-pay and deductible.