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Radiology Sonographer Doppler Scan Ordering - Adult - Ambulatory [161]

Radiology Sonographer Doppler Scan Ordering - Adult - Ambulatory [161] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Delegation/Practice Protocols, Ambulatory Delegation Protocols



Delegation Protocol Number: 161

Delegation Protocol Title:
Radiology Sonographer Doppler Scan Ordering - Adult - Ambulatory

Delegation Protocol Applies To:
UW Health Radiology

Target Patient Population:
Patients scheduled for a Testicular or Transvaginal Ultrasound

Delegation Protocol Champions:
Christopher Meyer, MD - Department of Radiology
Mark Kliewer, MD - Department of Radiology
Tyler Prout, MD - Department of Radiology

Delegation Protocol Reviewers:
Brian Sparland - Manager, Radiology – Ultrasound
Gina Greenwood, Director, Radiology Services
Carol Hassemer, MHA - Director of Clinical Operations/Medical Imaging
Carol Tomerlin - Radiology Coding
Dana Walker - Manager, Radiology - Ultrasound

Responsible Department:
Department of Radiology

Purpose Statement:
To delegate authority from the provider ordering a testicular or transvaginal Ultrasound to the
Sonographer to enter orders for Ultrasound Doppler exams, when indicated for radiology study
protocols.

Who May Carry Out This Delegation Protocol:
Sonographers trained in the use of this protocol.

Guidelines for Implementation:
1. This delegation protocol is initiated when a patient is scheduled for a testicular or transvaginal
Ultrasound and the Sonographer finds it necessary for radiology study protocols as outlined by the
American Institute of Ultrasound in Medicine handbook to add a Doppler scan due to the diagnosis
or pathology that presents itself on the initial exam.
2. The Sonographer will review the order to see if the reason for exam supports Doppler imaging or if
during the initial scan pathology indicates a Doppler is needed.
2.1.1. If the prescribing provider is a UW Health provider, the Sonographer will place an order for
a Doppler: Testicular Combination with Doppler [R07704] or Transvaginal Combination
with Doppler [R07703]. To avoid duplication, prior to placing any orders the Sonographer
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org


will review the patient’s medical record to determine if an active order for the Doppler
scan has been previously placed.
2.1.2. If the prescribing provider is not a UW Health provider, the Sonographer will contact the
provider’s office to send a signed order for the Doppler. If the non-UW Health provider is
unavailable, the Doppler portion will not be performed and the patient will be rescheduled
after the order for the Doppler has been obtained from the provider.

Order Mode: Cosign Required, Protocol/Policy

References:
American Institute of Ultrasound in Medicine Handbook

Collateral Documents/Tools: N/A

Approved By:
UW Health Ambulatory Protocol Committee: July 2017
Radiology: July 2017
UW Health Center for Knowledge Management Council: August 2017
UWHC Medical Board: September 2017
UW Health Chief Medical Officer: October 2017

Effective Date: October 2017

Scheduled for Review: October 2020
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
11/2017CCKM@uwhealth.org