Referral Best Practices for GPs: Writing Imaging Referrals That Work

A well-written referral does three things: it gets the right scan performed, it helps the radiologist produce a more useful report, and it ensures Medicare eligibility is clear.

A poor referral - vague indication, missing clinical context, wrong body part specified - can result in: • The scan being declined by the clinic or modified without your knowledge • A Medicare audit query if the indication doesn't match the item number • A radiologist report that misses what you're actually looking for • A callback to your practice for clarification, delaying the patient's imaging • The patient needing a second scan because the first was suboptimal

Most referral issues are avoidable with a consistent template and a few extra seconds of clinical specificity.

Every imaging referral should contain:

1. Patient details - Full name, date of birth, Medicare number 2. Date of referral - Required for Medicare (GP referral valid 12 months, specialist 3 months) 3. Your details - Provider name, provider number, practice address and phone 4. Scan type and body part - Specific modality (MRI, CT, ultrasound) and region (e.g., "MRI right knee") 5. Clinical indication - The specific clinical question (e.g., "Suspected ACL tear following sporting injury") 6. Relevant history - Duration of symptoms, prior imaging, relevant conditions 7. Examination findings - What you found clinically that supports the request 8. Relevant contraindications - Contrast allergy, renal impairment, metal implants, pregnancy 9. Urgency - Routine, urgent, or emergency 10. Whether contrast is required - If you have a preference, specify it (though the radiologist has discretion)

Missing any of these elements creates friction in the booking and reporting process.

The clinical indication is what drives the radiologist's search pattern and what Medicare uses to determine eligibility.

Good examples: • "MRI right knee - suspected medial meniscal tear. 42M, twisting injury 3 weeks ago, medial joint line tenderness, positive McMurray test. X-ray NAD." • "CT abdomen/pelvis with contrast - new weight loss 8kg over 3 months, change in bowel habit. ?Colorectal malignancy." • "Ultrasound abdomen - right upper quadrant pain, suspected cholelithiasis. Fatty food intolerance, elevated ALP."

Poor examples: • "?Pathology" • "As discussed" • "Review" • "Patient request" • "Back pain" (no duration, no exam findings, no differentials)

The radiologist reads your indication before they look at a single image. A clear indication tells them what to look for and what to rule out. This directly improves the quality of the report you receive.

Whether to specify contrast on the referral depends on the clinical question:

When to specify contrast: • Suspected vascular pathology (CT angiography, MRI angiography) • Cancer staging or monitoring (CT chest/abdomen/pelvis with contrast) • Hepatic or renal mass characterisation • Post-operative assessment for surgical complications

When to leave it to the radiologist: • Most neurological MRI (they'll decide based on protocol) • Most joint MRI (contrast rarely needed unless inflammatory arthropathy)

If the patient has a contrast allergy, renal impairment (eGFR <45), or is on metformin, always document this on the referral - it affects the pre-scan workup and may change the protocol. The clinic will likely call you if this isn't included and contrast is needed.

Digital referrals are increasingly common in Australian general practice and offer significant advantages:

• Instant delivery to the imaging clinic - no lost fax, no patient forgetting to bring the referral • Pre-filled patient details reduce transcription errors • Some platforms (including Radly's Practitioner Portal) allow you to specify scan type, clinical indication, and track whether the patient has booked • Better audit trail for your records

For a full overview of how digital referrals work and how to set them up for your practice, see our Digital Referrals Explained guide.

In Australia: • GP referral validity: 12 months from the date of issue • Specialist referral validity: 3 months unless specified as indefinite • Emergency referrals: Remain valid until the acute episode resolves

Patients sometimes present to imaging clinics weeks or months after you wrote the referral. Ensure the date is clearly written and that the clinical context still applies.

If a patient has had the scan elsewhere and the results influenced your management, update your records accordingly. If follow-up imaging is likely (e.g., monitoring a nodule), write the next referral at the follow-up appointment to avoid the patient needing to return just for a referral.