
Referring Physician Resources
Finding the best radiology care for your patient is as easy as 1-2-3
Diagnostic Radiology Referral
1. Order the appropriate imaging study
Example:
Indication: post-prandial right upper quadrant abdominal pain
Study requested: RUQ Ultrasound
We accept outside referral forms or if you prefer, you can use these standardized outpatient radiology requisition forms.
Not sure which study is appropriate for your patient? Please refer to the American College of Radiology (ACR) Appropriateness Criteria for guidance.
2. Obtain prior authorization from the patient's insurance provider
Some studies will require prior authorization, this varies depending on patient's insurance provider
This will ensure timely scheduling of your patient's exam and avoid any delays.
3. Fax the order to 518-314-3890
For all CVPH imaging referrals
This includes the following locations of service:
CVPH (Main Hospital)
CVPH Diagnostic Center
CVPH Open MRI
Valcour Imaging
Vascular & Interventional Radiology Referral
1. Send VIR referral with patient diagnosis
Example:
"Consult to Interventional Radiology for evaluation of right lower extremity claudication."
Not sure if IR is appropriate for your patient? Please refer to Society of Interventional Radiology (SIR) Physician's Guide to IR.
If you're still not sure, please call 518-562-7500 and ask to speak with one of our expert IR physicians.
2. Provide History & Physical (H&P) within 30 days including plan stating that IR referral is needed
Example:
"ASSESSMENT: 62yo hypertensive, diabetic male smoker with progressive right lower extremity pain on ambulation. Noninvasive arterial imaging including PVR/segmental studies and CTA abdomen/pelvis with runoff demonstrate significant peripheral arterial disease (PAD).
PLAN: Refer to IR for evaluation and treatment of suspected symptomatic PAD"
3. Forward relevant imaging for review
Example:
For prior imaging obtained at CVPH, no additional work is needed.
For prior imaging obtained at an outside institution, please forward imaging and report. Contact Ashlie Raudenbush for instructions.
VIR Clinical Coordinator:
Ashlie Raudenbush
Radiology Support Specialist II
Interventional Radiology
Ph: (518) 314-3596
Fax: (518) 562-7994
Email: araudenbush@cvph.org