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How to write order for x ray


D. Diagnostic Tests

1. Ordering of Diagnostic Tests In our November 22, 1996 final rule for the 1997 physician fee schedule (61 FR 59490), we revised § 410.32 (Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions) to state that, to be covered, diagnostic tests had to be ordered by the physician who treats the patient.


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An “order” is a communication from the treating physician/practitioner requesting that a diagnostic test be performed for a beneficiary.

While a physician order is not required to be signed, the physician must clearly document, in the medical record, his or her intent that the test be performed.


Last edited by RebeccaWoodward*; 11-23-2010 at 01:29 PM. Reason: ADDED LINKS

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Note that there was a companion piece on radio astronomy proposals by Ed Fomalont.
- Editor. Chance of Success

Each year there are 700-800 proposals for Chandra observations, archival work, and theory projects. Because of observing time and funding limits, only about 200 are accepted, one in four. The numbers for Cycle 5 were:

Type Submitted Accepted Observing Time
Normal 606 173 70 ks (ave)
Large Project 68 10 300-1000 ks
Archive 71 17
Theory 40 8
Total 785 208 19,400 ks

Table 3: Chandra observing proposals.

Chandra proposals are solicited once a year. The Call for Proposals contains schedule and rules. The Proposerуs Observatory Guide contains instrument descriptions. Software for feasibility calculations, information, and help are available at http://cxc.harvard.edu/.


If a proposal is truly excellent, and the review panel recognizes this, it will quickly be approved. However, 85% of proposals submitted are considered "good" and reviewers spend most of their time ranking the "good" proposals. Your challenge is to write the proposal so the excellence of the project is clear to the panel; or, at least, produce a clear, pleasing document that will stand out in the pack of "good" proposals.

The Peer Review

Proposals are divided among 12 or 13 panels according to science topic. Each science topic is covered by 2 or 3 panels so proposals can be placed to avoid conflicts. There are ~65 proposals/panel and 8 reviewers/panel.

Before the review, each panelist reads all proposals and assigns a preliminary grade. These grades are used for Triage. The first task for each panel is to view the list of the lowest-ranked proposals. The bottom 25% (~15 for each panel) are then eliminated from further consideration. However, if a panelist thinks any proposal in this group should be considered further, it can be resurrected and discussed with the rest. The panel then discusses and grades the remaining 50 proposals - about 10 minutes for each! Each has been assigned a primary and a secondary reviewer who are responsible for a detailed reading of the proposal, presentation to the panel, and writing of a report communicating the grade and panel comments for the proposer.

On the third day of the review, the Large Projects, already graded by the topical panels are discussed and ranked by a Big-project panel which awards 20-30% of the observing time.

An order may be delivered via the following forms of communication:

A written document signed by the treating physician/practitioner, which is hand-delivered, mailed, or faxed to the testing facility; NOTE: No signature is required on orders for clinical diagnostic tests paid on the basis of the clinical laboratory fee schedule, the physician fee schedule, or for physician pathology services;

A telephone call by the treating physician/practitioner or his/her office to the testing facility; and
An electronic mail by the treating physician/practitioner or his/her office to the testing facility.

Chernecky CC, Berger BJ. Chest radiography (chest x-ray, CXR) - diagnostic norm. In: Chernecky CC, Berger BJ. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:327-328.

Gotway MB, Panse PM, Gruden JF, Elicker BM. Thoracic radiology. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 18.

All proposers are treated equally. Reviewers are conscientious and fair but this is an intense process. There is a lot to accomplish in a limited time. Proposers should retain the perspective of Ecc 9:11 where, "the race is not to the swift, nor the battle to the strong, nor bread to the wise , nor riches to the intelligent, nor observing time to the writers of good proposals, but time and chance happen to them all."

Start early. Donуt wait until the last minute.
Write some of the description for someone who is not an expert in the field. Remember some of the panelists do not work in your specific area and the proposal has to survive triage.
Print the proposal and read it before submitting.
Avoid unnecessary Coinvestigators. Reviewers cannot participate in reviews of proposals for which they are CoIs and sometimes for those which have CoIs from their institutions.
Volunteer to be a peer reviewer. Having seen the process you will be able to write better proposals.

Fred Seward
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[email protected] The proposal must show that the observing time requested will produce enough signal (counts for X-rays) to do the job. It must also demonstrate that Chandra capabilities (e.g. arcsecond resolution) are needed.

You can write a single proposal (for example) for Chandra Time and VLA/VLB, NOAO, HST, XMM, RXTE, or Spitzer time. The Chandra review can award up to a few percent of the observing time on another instrument to such joint proposals (subject to approval of the appropriate Director). The proposal must show that both Chandra and the other instrument are essential to meet scientific objectives, and must demonstrate feasibility for each.

Format Two sections comprise a Chandra proposal:
The Target Form contains investigator information, target details, and instrument settings.
The Science Justification is a little science paper; length limited to 4 pages (6 for Joint Proposals or Large Projects), explaining the scientific basis of the project and showing feasibility calculations.

Take care to avoid mistakes. Misspelling investigator or institution names negate the use of the computer to find conflicts of interest.


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