INTERVENTIONAL RADIOLOGY
2025 Med
& Lab Guidelines / 2018
SIR Antibiotic Prophylaxis Practice Parameters
Procedure - Prep Instructions / Aftercare Instructions / Patient Handouts
Procedure Approval Forms - Biopsy / Specials / Breast
Procedure
Worksheets - CT
/ US
/ Fluoro
/ IR / Breast
Procedure Charge Sheets - CT / US / Breast
Consult & H&P Forms - IR
Consult / Full
H&P / H&P
Update (No Change)
Cryoablation Probe Info / Histotripsy
Procedure Plan
Laboratory Order Forms - Body Fluid / Blood
Other - Fluid Specimen Handling / Local Anesthesia Limits / Breast Biopsy Clip Metal Composition
Patient Appointment Letters (Risk NPO Driver) - Low No No / Low No Yes / Low Yes Yes / High Yes Yes / Procedure w/ Consult
Orders Project (Not for
Providers to Use)