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New Privilege List - DI / Radiation Oncology - Sutter Medical Center

New Privilege List - DI / Radiation Oncology - Sutter Medical Center

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<strong>Sutter</strong> <strong>Medical</strong> <strong>Center</strong>, Sacramento<br />

Department Of Diagnostic Imaging & <strong>Radiation</strong> <strong>Oncology</strong> - Delineation Of <strong>Privilege</strong>s<br />

NAME:<br />

Request <strong>Privilege</strong> Appointment Requirements Proctoring Required<br />

Coronary CT Angiography – Continued<br />

3. Completed at least 40 hours of category I continuing<br />

medical education (CME) in cardiac imaging,<br />

including cardiac CT/coronary CTA anatomy,<br />

physiology, and/or pathology or documented<br />

equivalent supervised experience in a center actively<br />

performing coronary CTA. Documentation of<br />

CME can be by copies of certificates or listing of<br />

CME programs with date, title of program and<br />

number Category 1 CME credits granted.<br />

Reappointment<br />

Requirements<br />

Number<br />

Performed<br />

[ ] II. INTERVENTIONAL RA<strong>DI</strong>OLOGY Radiography Certificate Required. First five (5) cases<br />

AND<br />

Evaluations at 3, 6 &<br />

12 Months<br />

[ ] Central venous catheter placement with<br />

subcutaneous tunnel<br />

[ ] Central venous catheter placement without<br />

subcutaneous tunnel<br />

[ ] Transvenous repositioning a central venous catheter<br />

[ ] Transvenous extraction of central venous catheter<br />

fragment<br />

[ ] Central venous catheter placement with<br />

subcutaneous port<br />

[ ] Removal of central venous catheter either tunneled<br />

or with subcutaneous port<br />

[ ] Exchange of central venous catheter either tunneled<br />

or non-tunneled<br />

[ ] Transvenous stripping of central venous catheter<br />

[ ] Thrombolytic infusion for non-functioning central<br />

venous catheter<br />

[ ] Thrombolytic infusion for deep venous thrombosis<br />

[ ] Venous angioplasty<br />

[ ] Parathyroid and thyroid venous sampling<br />

[ ] Renal venous sampling<br />

[ ] Adrenal venous sampling<br />

[ ] Visceral venous sampling<br />

[ ] Wedge hepatic venogram<br />

[ ] Wedge hepatic venous pressure measurement<br />

[ ] Trans splenic portal venogram<br />

Page 4 of 17<br />

Note: Approval is subject to the terms of the hospital's exclusive contract for Radiology services, i.e., approval is for second opinion consultations only, it being understood that the<br />

hospital's contracting Radiologists are primarily responsible for these services.

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