#4795
Expert Nurse
Suzanne McGettigan

I can only ditto what others have said.
We, too, have a centralized radiology pre-cert team, made up of non-clinical staff. They submit the initial request for prior authorization, along with labs/path/most recent progress note. When it still requires a peer to peer discussion (with the MD/NP/PA), we receive these requests very close to the time of the scan. Since these discussions now have to be “scheduled”, it is more and more challenging to have them completed prior to the original scheduled time of the scan and these often have to be rescheduled, along with the patient’s office visit.
PET/CTs have become almost impossible to get approved other than at the time of initial diagnosis or as a follow up to equivocal findings on “standard” imaging. We have updated our clinical pathways to reflect this restriction and utilize CT c/a/p +/- neck or extremity for surveillance imaging in NED patients and for monitoring response to therapy in other patients.