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
Comments
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

780-492-9271

Any concerns or questions please call

Central Referrals: 780-248-1935 ​