UC Davis Comprehensive Cancer Center
Use the guidelines on this page to refer patients to UC Davis Comprehensive Cancer Center for cancer specialty care.
To help expedite your referral, include:
- Subspecialty or clinical indication
- Required clinical documentation
- Approved CPT codes
Subspecialty or Indication
Reason For Referral
- Bone Marrow
Required Medical Records
- Initial history and physical (past 3 months)
- Hematology/Oncology consult (past 24 months) Immunophenotyping report (past 24 months)
- Labs (past 24 months)
- Tumor marker and genetic labs (past 24 months)
- Genetic bone marrow results (ALL)
- Discharge summary (past 12 months)
- Pathology reports (past 24 months)
- Radiology reports (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Brain
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Initial consultation
- Radiation treatment summary (past 24 months)
- Chemo flowsheets (past 24 months)
- Labs (past 24 months)
- Tumor marker and Genetic labs (past 24 months)
- Operative reports (past 24 months)
- Pathology reports (past 24 months)
- Radiology reports (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Breast Cancer
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Radiation treatment summary (past 24 months)
- Chemo flowsheets (past 24 months)
- Labs (past 24 months)
- Tumor marker and Genetic labs (past 24 months)
- Operative reports (past 24 months)
- Pathology reports (past 24 months)
- Radiology reports (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Breast Health
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Radiation treatment summary (past 24 months)
- Chemo flowsheets (past 24 months)
- Labs (past 24 months)
- Tumor marker and Genetic labs (past 24 months)
- Operative reports (past 24 months)
- Pathology reports (past 24 months)
- Radiology reports (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Dermatology
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Chemo flowsheets (past 24 months)
- Operative reports (past 24 months)
- Pathology reports (past 24 months)
- Radiology reports (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Endocrine
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Pathology Reports (past 24 months)
- Radiology Reports (past 24 months)
- Labs (past 24 months)
- Tumor Marker and Genetic Labs (past 24 months)
- Radiation Treatment Summary (past 24 months)
- Operative Reports (past 24 months)
- Nuclear Medicine (Thyroid) Scan
- Nuclear Medicine (Sestamibi) Scan
- Operative Reports (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Fine Needle Aspiration
Required Medical records
- NA
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Gastrointestinal Cancer
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Chemo Flowsheets (past 24 months)
- Labs (past 24 months)
- Tumor Marker and Genetic Labs (past 24 months)
- Pathology Reports (past 24 months)
- Radiology Reports (past 24 months)
- Radiation Treatment Summary (past 24 months)
- Colonoscopy with Path (past 24 months)
- Operative Reports (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Genitourinary Cancer
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Chemo Flowsheets (past 24 months)
- Labs (past 24 months)
- Tumor Marker and Genetic Labs (past 24 months)
- Pathology Reports (past 24 months)
- Radiology Reports (past 24 months)
- Radiation Treatment Summary (past 24 months)
- Operative Reports (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Gynecologic Oncology
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Pap Smear (past 24 months)
- Chemo Flowsheets (past 24 months)
- Labs (past 24 months)
- Tumor Marker and Genetic Labs (past 24 months)
- Pathology Reports (past 24 months)
- Radiology Reports (past 24 months)
- Radiation Treatment Summary (past 24 months)
- Operative Reports (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Head and Neck
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Chemo Flowsheets (past 24 months)
- Labs (past 24 months)
- Tumor Marker and Genetic Labs (past 24 months)
- Pathology Reports (past 24 months)
- Radiology Reports (past 24 months)
- Radiation Treatment Summary (past 24 months)
- Endoscopies (past 24 months)
- Esophagogastroduodenoscopy (past 24 months)
- Bronchoscopy (past 24 months)
- Laryngoscopy (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Malignant Hematology
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Chemo Flowsheets (past 24 months)
- Labs (past 24 months)
- Tumor Marker and Genetic Labs (past 24 months)
- Pathology Reports (past 24 months)
- Radiology Reports (past 24 months)
- Medication List (past 24 months)
- HIV and AIDS Testing (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Melanoma
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Chemo Flowsheets (past 24 months)
- Labs (past 24 months)
- Tumor Marker and Genetic Labs (past 24 months)
- Pathology Reports (past 24 months)
- Radiology Reports (past 24 months)
- Radiation Treatment Summary (past 24 months)
- Discharge Summary (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Miscellaneous Cancers
Required Medical Records
- NA
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Pediatric Hematology-Oncology
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Labs (past 24 months)
- Pathology Reports (past 24 months)
- Radiology Reports (past 24 months)
- Current Treatment Plan
- Current Medication List and Doses
Requested CPT Codes
- 99205
- 99245
Reason for Referrals
- Psych Oncology
Required Medical Records
- NA
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Sarcoma
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Labs (past 24 months)
- Pathology Reports (past 24 months)
- Radiology Reports (past 24 months)
- Chemo flowsheets (past 24 months)
Requested CPT Codes
- 99205
- 99245
Reason for Referral
- Thoracic
Required Medical Records
- History and physical (most recent)
- Progress notes (most recent)
- Labs (past 24 months)
- Pathology Reports (past 24 months)
- Radiology Reports (past 24 months)
- Tumor Marker and Genetic Labs (past 24 months)
- Radiation Treatment Summary (past 24 months)
- Operative Reports (past 24 months)
- Discharge Summary (past 24 months)
- Pulmonary Function Test (past 24 months)
- Surgical OP Reports (past 24 months)
Requested CPT Codes
- 99205
- 99245
Authorization Information
| Clinic Location | Tax ID | NPI |
|---|---|---|
| Hospital | 946036494 | 1710918545 |
| Sacramento | 680344702 | 19624825513 |
| Folsom | 680344702 | 1003896648 |
| Rocklin | TBD | TBD |