Ultrasound order form 2025

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The document is an ultrasound order form from the Radiology Department at Emanuel Medical Center, detailing various ultrasound studies available for patients. It includes sections for patient information, ordering physician details, diagnosis/symptoms, appointment specifics, and a comprehensive list of ultrasound procedures along with their corresponding CPT codes.

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Click ‘Get Form’ to open the ultrasound order form in the editor.
Begin by entering the 'Order Date' and the 'Ordering Physician' details at the top of the form. This information is crucial for processing your request.
Fill in the 'Patient Name', 'D.O.B.', and 'Appt Date' fields to ensure accurate identification and scheduling.
In the 'Diagnosis/Symptoms' section, provide relevant medical information that justifies the ultrasound procedure.
Select the appropriate study description from the list provided, such as 'US Abdominal Aorta' or 'US Pelvic Sonogram'. Ensure you also note down the corresponding CPT code for billing purposes.
Complete any additional fields like 'Precert Number' and 'Appt Time' to finalize your order.
Finally, have the ordering physician sign in the designated area before submitting your form.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the most accurate ultrasound for pregnancy?

Ultrasound measurement of the embryo or fetus in the first trimester (up to and including 13 6/7 weeks of gestation) is the most accurate method to establish or confirm gestational age.

Which ultrasound is most important in pregnancy?

The dating scan with cardiac activity is considered the most important one. This scan is usually done between 8-14 weeks of pregnancy and aims to confirm the gestational age, assess foetal growth and development, and detect any potential abnormalities.

What does ordering an ultrasound mean?

Ultrasound, also called sonography, shows the structures inside the body. The images can help guide diagnosis and treatment for many diseases and conditions. Most ultrasounds are done using a device outside the body. However, some involve placing a small device inside the body.

What kind of ultrasound is needed for pregnancy?

Transvaginal ultrasound In early pregnancy, this ultrasound helps to detect a fetal heartbeat or determine how far along you are in your pregnancy (gestational age). Images from a transvaginal ultrasound are clearer in early pregnancy as compared to abdominal ultrasound.

What ultrasound should I order for pregnancy?

Types of scans during pregnancy Early pregnancy or dating scan (8-11 weeks) Nuchal Translucency scan (11-14 weeks) Early Anomaly scan (14-18 weeks) Fetal Anomaly scan (19-23 weeks) Growth scan or Fetal Wellbeing scan (24-42 weeks) Recommended at 36 weeks. Optional - four weekly, more frequently in some conditions.

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Do you need a doctor order for an ultrasound?

Most healthcare providers require a referral in order to receive an ultrasound. However, that can seem daunting, especially if you dont have insurance or a primary care provider.

Can you order your own ultrasound?

Answer: All diagnostic or medical ultrasounds do require a provider, physician or practitioner referral that shows the exam is being ordered for medical purposes.