27 - Referral for capsule endoscopy

GI Diagnostic Code Suggested Waiting Time / Priority Level Referral Information Requirements
  1. Referral for capsule endoscopy
    Not usually a Family Physician direct referral (either directly referred or recommended by a Gastroenterologist/Internal Medicine or a surgeon that has seen and scoped the patient)
    • Post over GI Bleed (which has stopped)
    • Obscure GI Bleed

  • Urgent
  • Semi-Urgent
  • Indication / question to be answered
  • Relevant medications eg NSAIDs, Iron
  • Relevant imaging studies (Gastroscopy, Colonoscopy, CT Scan, etc.)
Essential Investigations Timing of essential investigation 
  • CBC, Creatinine, BUN (if patient is actively bleeding)
  • Ferritin (if done)
  • Iron Studies (if done)
  • Within 1 month unless acute
  • 3 months
  • 3 months
Copies of relevant imaging should have been undertaken within the last year and/or when the patient has had a drop in Hgb/Ferritin or an active GI bleed (melena, maroon or copious BRPR)?

Fill out the Hepatology Referral Form for your patient in its entirety

Fax completed referral package to


Any concerns or questions please call

Central Referrals: 780-248-1935 ​