Template Letters to Document 300 Cases
Print only versions of these templates are also available and can be found on the Forms and Templates page.
* NOTE: For the purpose of Certification, a study performed and/or interpreted may be counted only once. For example, although add-on codes are used for gated SPECT studies, this should count as only 1 case.
The EXACT number of studies performed and interpreted must be provided. Applications containing approximated and/or rounded numbers will NOT be reviewed by the Certification Committee. Letters documenting level of service MUST be on appropriate letterhead.
**In the absence of a formal director of the nuclear cardiology laboratory or if the applicant is the director of nuclear cardiology, the letter should be written by the practice’s President, CEO, or Business Manager.
* NOTE: For the purpose of Certification, a study performed and/or interpreted may be counted only once. For example, although add-on codes are used for gated SPECT studies, this should count as only 1 case.
The EXACT number of studies performed and interpreted must be provided. Applications containing approximated and/or rounded numbers will NOT be reviewed by the Certification Committee. Letters documenting level of service MUST be on appropriate letterhead.
**In the absence of a formal director of the nuclear cardiology laboratory, the letter should be written by an appropriate supervising physician. If applicant is the Medical Director of the Nuclear Cardiology Laboratory, the letter should be from the Chief of Cardiology or the Chief of Staff of the Hospital.