Documentation and Correction of the RME

Question 1

RME Block 1

Answer 1

Type of Exam

Question 2

RME Block 2

Answer 2

Examining facility

Name
Address
Phone Number

Question 3

Block 3-10

Answer 3

Medical History

Yes, answers require further evaluation, comments in block 14

Question 4

Block 11

Answer 4

Dated CBC lab results

Question 5

Block 12

Answer 5

Dated UA lab results for dipstick or microscopy

Question 6

Block 13

Answer 6

Additional studies. For tests performed in addition to the special studies required for the RME.

Repeat CBC/UA are not additional studies

Question 7

Block 14

Answer 7

Summary of abnormal findings. Repeat labs. Determination of CD or NCD.

Question 8

Block 15-19

Answer 8

Physical Exam

Question 9

Block 20

Answer 9

Examiner mark PQ or NPQ. NPQ, a REAB submission is required. REAB will respond with a letter, that information is captured in block 20b.

Question 10

Block 21

Answer 10

Patient Signature and Date

Question 11

Block 22

Answer 11

Printed Name of examiner, Signature and date

Question 12

Block 23

Answer 12

Printed Name of reviewing physician, signature, date

Question 13

Block 24

Answer 13

Pt information

Question 14

Describe what makes an RME deficient and how to correct deficiency.

Deficient in clinical scope, or found lacking on audit

Answer 14

clinical studies and procedures will be performed which satisfy the missing requirements

information added in the summary of abnormal findings block

Deficiency is unable to be resolved, then patients radiation worker status should be suspended. placed on DINA status

Question 15

Describe what makes an RME deficient and how to correct deficiency.

Once the examination is sufficient in clinical scope to meet the requirements of a RME.

Answer 15

Tests and examination elements performed and interval history will be entered in notes block and signed dated by reviewing physician.

Question 16

Approved methods for making administrative corrections on an RME.

Answer 16

One line, date/initial

Corrected entries may also be made in the summary of abnormal findings. (Block 14)

Non-clinicians should not add comments or other information that could carry clinical meaning.

Question 17

Filing Requirements of the RME and associated Documentation.

NAVMED 6470/13

Answer 17

Filed on top of section 3 of health record

Lab: Section 4

Path Reports: Sec 4

Results: Radiobioassay section 1

Exposure Results: section 1 in front of refernce audiogram

Consultations and corresponding SF600 section 2,
consultations reports shall be readily accessible in med record.