For Our Referrers

Order Request Forms

 

Order Request Forms
A4 Computer General A5 General A5 Cardiothoracic A5 Dental/Orthodontic A4 Computer MRI A5 MRI A5 Spinal Interventional A4 Computer Nuclear Medicine A5 Nuclear Medicine
1 2 3 4 5

PACS

 

PACS (Picture Archiving and Communication System) allows you to review your patient's results online. Electronic images and reports are digitally sent to PACS upon completion, thereby giving you timely and efficient results.

 

To register for PACS, please click on the link below. Your submission will be reviewed by our PACS administrator, upon verification you will receive an email with all the necessary details.

 

Register for PACS.

 

Already registered? Access your patients results here.

Request Form PDF

 

Printable referrals will be available soon. Please check back at a later date.

Upright MRI Mailing List

You can subscribe to our Upright MRI mailing list to receive information regarding interesting cases.

Upright MRI Mailing List

Bulk Billing Guide

 

MAMMOGRAPHY

 

To ensure that your patients are eligible for BULK  BILLING, please note the following MEDICARE RULES

 

Unilateral vs Bilateral Mammography

  • Medicare can interpret a referral for a “Mammogram/Mammography” as a SINGLE BREAST examination only
  • “ Bilateral Mammogram/Mammography” must be indicated on the referral form to appropriately allow the radiological examination of both breasts for Medicare purposes

 

Indications Approved by Medicare

  • Symptoms/signs or suspicion of breast MALIGNANCY found on an examination

  • PAST HISTORY or occurrence of breast MALIGNANCY in the patient or FAMILY HISTORY OF MALIGNANCY

  • The presence or suspicion of a LUMP or MASS

  • The presence of LOCALISED BREAST PAIN OR TENDERNESS

 

INDICATIONS NOT APPROVED BY MEDICARE

  • NO clinical indication or SCREENING
  • CYST or FOLLOW UP CYST
  • GENERALISED/CYCLICAL TENDERNESS
  • FOLLOW UP PREVIOUS BENIGN LUMP

 

SHOULDER ULTRASOUND

 

Indications approved by Medicare

  • Evaluation of injury to tendon or muscle
  • Rotator cuff tear, calcification or tendinosis
  • Biceps subluxation
  • Capsulitis or bursitis
  • Evaluation of mass/swelling
  • Occult fracture
  • Acroioclavicular joint pathology

 

Indications Not Approved By Medicare

  • Shoulder pain

 

KNEE ULTRASOUND

 

Indications Approved By Medicare

  • Tendon abnormality
  • Meniscal cyst, popliteal cyst or swelling e.g. Baker's cyst
  • Nerve entrapment or tumour
  • Collateral ligament injury

 

Indications Not Approved By Medicare

 

  • Knee pain
  • Meniscal or cruciate ligament tears
  • Assessment of arthritis/chondral surfaces

 

DXA

 

12306 - 2 Years

  • Patient HAS osteoporosis (is not testing for it - proven via CT or x-ray)
  • Minimal trauma fractures
  • Loss of height at least 20% - Shown via CT or x-ray
  • Progress

 

12312 - 1 year

  • Prolonged steroid use
  • Asthma - on steroid medication
  • Early menopause or history of hysterectomy before 44 years 6 months of age

 

12315- 2 years

  • Thyroid disease
  • Liver failure
  • Renal disease
  • Rheumatoid arthritis - has to be this particular kind
  • Vitamin D deficiency
  • Crohn's disease

 

12321 - 2 years

  • Change in medication (therapy) associated with one of the above conditions

 

12323 - 2 years

  • Over 70 years of age

 

INDICATIONS NOT COVERED BY MEDICARE

  • Initial DXA to determine whether the patient has osteoporosis

Privacy Statement  Disclaimer

Copyright © 2017 Western Imaging Group. All Rights Reserved.