What diagnostics can NPs order independently

[DelightfulNP]

Hi everyone,

I am getting ready to write the AANP next month and as a Canadian-trained NP student, I am not too familiar with what diagnostic tests NPs are authorized to order. I know in Ontario, Canada, NPs cannot order CTs and MRIs, therefore, one must consult a physician partner via a collaborative practice agreement. I would like to get some general direction on what diagnostic tests NPs are authorized to order independently and which ones they must consult.

Thank you in advance,

[BCgradnurse, MSN, RN, NP]

I can order anything I need to. I do not require physician approval or oversight to order whatever diagnostics I deem appropriate. Some practices may have their own rules where they require some type of authorization from a MD.

That being said, there's no guarantee that insurance will approve payment for whatever I order, so there's often a lot of paperwork that needs to be done explaining the necessity of the test or procedure.

[Rnis, BSN, DNP, APRN, NP]

Um I order pretty much anything...... definitely CT's and mris

[DelightfulNP]

Ok great. So for testing purposes, I am under the impression that NPs can order whatever test is necessary for the patient.

Thank you for your help.

[JellyDonut]

In clinic anything...however, there are some off medicate rules about rehab and home care. In patient is different, you require sign off by MD (i have been told this is still the case in full practice states, but i have not confirmed it).

[KelRN215, BSN, RN]

In my 11 year career, the only thing I have known that has to be ordered by an MD (as opposed to an ARPN or PA) is home health nursing. In my state, 485s must be signed by MDs. But NPs definitely do ordering for labs and radiology procedures independently.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I'm not in Canada, but I order what I need, even angio's and CRTD placement! I work in cardiology.

[BrnEyedGirl, BSN, MSN, RN, APRN]

In my 11 year career, the only thing I have known that has to be ordered by an MD (as opposed to an ARPN or PA) is home health nursing. In my state, 485s must be signed by MDs. But NPs definitely do ordering for labs and radiology procedures independently.

Oh my,..you are right,..I can order insulin, but not diabetic shoes!!

[InquisitiveAPN]

The differences will likely be with the organization who owns or leases the test machine OR the insurance company reimbursing although I've never had one deny imaging let alone labs.

[mschelee, MSN, RN]

For nurse practitioners I don't think the question really is about what you can order, it is more about what you should order. Meaning the less expensive test that works is the most appropriate one if you could order a CT, why order an MRI...