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| Ask patients to call (719) 524-8662 to schedule. | |||||||||||||||
| Current as of: 23 May 2012 | |||||||||||||||
| Clinic Location: | Premier Army Health Clinic. 3920 North Union Blvd. (SW corner of Union and Austin Bluffs). | ||||||||||||||
| Colorado Spring, CO 80907. | |||||||||||||||
| Hours of Operation: Mon - Fri 0800-1630 | |||||||||||||||
| Walk-in: | No | ||||||||||||||
| Consult | Yes | ||||||||||||||
| Required: | |||||||||||||||
| Self-Referral | No | ||||||||||||||
| Clinic: | |||||||||||||||
| Beneficiary | All Premier enrolled beneficiaries and any EACH OB patient. | ||||||||||||||
| Types: | |||||||||||||||
| Appt Types: | Detail Codes: | Duration: | Comments / Instructions: | ||||||||||||
| US-(body location) | 45 | New Orders for Ultrasound | |||||||||||||
| TO BE READ VERBATIM TO THE PATIENT | |||||||||||||||
| ► You are being scheduled at Premier Clinic Radiology for your appointment. | |||||||||||||||
| ► Be sure to follow the preparation instructions provided to you. | |||||||||||||||
| ► NO children are allowed in the exam room unless they are the patient. | |||||||||||||||
| ► Children under the age of 12 cannot be left unattended in the waiting areas. They must be accompanied by an adult at all times | |||||||||||||||
| while in the clinic. | |||||||||||||||
| ► For Routine OB exams you may have one adult accompany you to your appointment. | |||||||||||||||
| ► No cameras or video recorders are allowed in the exam room. | |||||||||||||||
| ► Follow these preparation instructions: (Provide patient instructions for their ultrasound based on the following list) | |||||||||||||||
| If the requested ultrasound is not found below, see “Special Instructions for Clerks” below for more information. | |||||||||||||||
| For the following studies: | |||||||||||||||
| US ABDOMINAL WALL | |||||||||||||||
| US APPENDIX | |||||||||||||||
| US CAROTIDS | |||||||||||||||
| US GROIN | |||||||||||||||
| US KNEE/POPLITEAL (LT) | |||||||||||||||
| US KNEE/POPLITEAL (RT) | |||||||||||||||
| US KNEE/POPLITEAL, BILAT | |||||||||||||||
| US NECK SOFT TISSUE | |||||||||||||||
| US OB TRANSVAGINAL | |||||||||||||||
| US SUPERFICIAL LESIONS | |||||||||||||||
| US TESTE | |||||||||||||||
| US THYROID | |||||||||||||||
| US TRANSVAGINAL | |||||||||||||||
| US VENOUS DOPPLER (UNILATERAL) | |||||||||||||||
| US VENOUS DOPPLER (BILATERAL) | |||||||||||||||
| Give the following instructions: | |||||||||||||||
| No prep required. | |||||||||||||||
| For the following studies: | |||||||||||||||
| US BLADDER (PVR) | |||||||||||||||
| US OB COMPLETE | |||||||||||||||
| US OB LIMITED | |||||||||||||||
| US PELVIS | |||||||||||||||
| US UMB CORD DOPPLER | |||||||||||||||
| Give the following instructions: | |||||||||||||||
| A full bladder is required, drink one quart of water in the following manner: | |||||||||||||||
| Drink one quart (32 oz.) of water starting 2 hrs prior to your appointment, finish drinking 1 hour prior to your exam. | |||||||||||||||
| Do not empty your bladder. If your bladder is not full, the exam may need to be rescheduled. | |||||||||||||||
| For the following studies: | |||||||||||||||
| US KIDNEY (BILAT) | |||||||||||||||
| US KIDNEY (LT) | |||||||||||||||
| US KIDNEY (RT) | |||||||||||||||
| Give the following instructions: | |||||||||||||||
| A full bladder is required. | |||||||||||||||
| Drink one pint (16 oz.) of water 1 hour prior to your appointment. Do not empty your bladder. | |||||||||||||||
| For the following studies: | |||||||||||||||
| US OB NUCHAL TRANSLUCENCY | |||||||||||||||
| Give the following instructions: | |||||||||||||||
| A full bladder is required. Drink one pint of water in the following manner: | |||||||||||||||
| Drink one pint of water (16 oz.) starting 2 hours prior to your appointment, and finish drinking 1 hour prior | |||||||||||||||
| to your exam. Do not empty your bladder. If your bladder is not full, the exam may need to be rescheduled. | |||||||||||||||
| For the following studies: | |||||||||||||||
| US ABDOMEN | |||||||||||||||
| US ABDOMINAL AORTA | |||||||||||||||
| US LIVER | |||||||||||||||
| US PANCREAS | |||||||||||||||
| US RUQ | |||||||||||||||
| US SPLEEN | |||||||||||||||
| US PYLORUS | |||||||||||||||
| Give the following instructions: | |||||||||||||||
| DO NOT eat or drink anything after midnight the night prior to your exam, or for 6 hours prior to your exam for | |||||||||||||||
| an afternoon appointment. | |||||||||||||||
| Special Instructions for CLERKS: | |||||||||||||||
| US OB COMPLETE exams for fetal anatomical survey are scheduled between 20 – 22 weeks gestational age. Use the Pregnancy | |||||||||||||||
| Calculator Wheel to get the appropriate date to prevent repeat exams. | |||||||||||||||
| US OB NUCHAL TRANSLUCENCY exams must be scheduled between 11-13+6 weeks gestational age (NO EXCEPTIONS). | |||||||||||||||
| Try to schedule between 11-13 weeks to ensure we do not miss the necessary window, with 12 weeks being the preferred goal. | |||||||||||||||
| If there is an LMP listed on the request use the Pregnancy Calculator Wheel and schedule accordingly. | |||||||||||||||
| OB LIMITED EXAM If there is no time reference on the referral, then book the next available appt that meets the patient's needs. | |||||||||||||||
| ► If a patient has more than one exam (i.e. US ABDOMEN and US PELVIS), the exams need to be put in separate slots to allow enough | |||||||||||||||
| time to complete each exam, and for the patient to follow appropriate prep. (At least 2 hours between to fill bladder etc). | |||||||||||||||
| UNLISTED ULTRASOUNDS | |||||||||||||||
| ► Breast Ultrasound requests: transfer to Kim at 526-7838 or Sue at 526-7986. | |||||||||||||||
| ► Other unlisted requests: transfer to the clinic at 526-7300. | |||||||||||||||
| Special Instructions for Lack of Availability: | |||||||||||||||
| ► If there are no appointments available, transfer the patient to clinic for assistance: 240# | |||||||||||||||