| Name (last, first ): | D`Agostino, Horacio R. |
| Degree: | M.D. |
| Title: | Professor & Department Head |
| Department: | Radiology |
| Section: | SPC |
| Status: | Active |
| Proctor: | |
| Sex (M,F): | M |
| Pager Number: | 934-6085 |
| Physician ID number: | 106690 |
| NPI Number: | 1184640682 |
LSU Health Sciences Center
Privilege Listing
D`Agostino, Horacio R.
Privilege Code Legend| 1203.1 | N | Diabetes |
| 1203.2 | N | Pulmonary |
| 1203.3 | N | Cardiac |
| 1204.1 | N | Pre-Operative Evaluation |
| 1204.2 | N | Pre-Medication |
| 1205 | N | PACU |
| 1205.1 | N | SICU |
| 1207 | N | Monitored anesthesia care |
| 1208 | N | General Anesthesia - Endotracheal Intubation |
| 1209 | N | Ventilator Mangement |
| 1210 | N | Regional blocks - Spinal |
| 1211 | N | Regional blocks - Epidural |
| 1212 | N | Regional Blocks - Caudal |
| 1214 | A | "A" Lines |
| 1215 | A | Central Lines |
| 1216 | A | Swan Ganz Catheter |
| 1217 | N | Cardiopulmonary Bypass |
| 1218 | N | Acute Postoperative Pain Management - Epidural |
| 1219 | N | Acute Postoperative Pain Management - Spinal |
| 1220 | N | Acute Postoperative Pain Management - Intrapulmonary catheters |
| 1221 | N | Acute Postoperative Pain Management - IVPCA |
| 1222 | A | Chronic Pain Management - Sympathetic blocks |
| 1223 | N | Chronic Pain Management - Lumbar |
| 1224 | N | Chronic Pain Management - Stellate |
| 1225 | A | Celiac plexus blocks |
| 1226 | N | Differential spinal diagnostic/therapeutic blocks |
| 1227 | N | Implantable catheters/spinal cord stimulator |
| 1228 | N | Acupuncture |
| 1229 | N | Myeloscopy |
| 1230 | N | Transesophageal Echocardiography |
| 1231 | A | Muscle Injection |
| 1232 | A | Joint Injections |
| 1233 | N | Epidural Injection |
| 1234 | N | Spinal Injection |
| 1235 | A | Disc Injection |
| 1236 | A | Morphine (subarachnoid/epidural) pump and neuro stimulator implantation/removal |
| 1237 | N | Nerve Blocks |
| 1238 | N | Radiofrequency Termocoagulation (RFTC) Neurolytic Blocks |
| 1239 | A | Discography |
| 1240 | A | Lasers |
| 1241 | N | Caudal Decompression/Lysis of Adhesions |
| 1242 | N | Caudal Epidural Steroid Injection/Intraspinal Myelography |
| 1243 | A | Celiac Plexus Block |
| 1244 | A | Cervical Facet Joint Injection |
| 1245 | N | Cervical Facet Nerve Injection |
| 1246 | N | Cervical Facet Rhizotomy |
| 1247 | N | Cervical Selective Nerve Root Block |
| 1248 | N | Cervical Epidural Steroid Injection/Intraspinal Myelography |
| 1249 | N | Cervical Epidural Steroid Injection/Intraspinal |
| 1250 | A | Discogram/Myelography |
| 1251 | N | Epidural Differential/Epidural Differential Flow Sheets |
| 1252 | A | Lumbar Epidural Steroid Injection/Intraspinal Myelography |
| 1253 | A | Lumbo-Sacral Selective Nerve Root Block |
| 1254 | N | Lumbar Sympathetic Rhizotomy |
| 1255 | N | Lumbar Sympathetic Block |
| 1256 | N | Neurolytic Celiac Plexus Block |
| 1257 | N | Obturator Nerve Block |
| 1258 | N | Psoas Compartment Block |
| 1259 | N | Trigger Point Injections |
| 1260 | A | Thoracic or Lumbar Facet Joint Injection |
| 1261 | N | Thoracic or Lumbar Facet Nerve Injection |
| 1262 | N | Thoracic Epidural Steroid Injection/Intraspinal Myelography |
| 1268 | A | PPMP - Physician Performed Microscopy Procedures **(Vertebroplasty) |
| 9000 | A | Acknowledgement of Clinician I understand that: (1) In exercising any clinical privileges granted, I am constrained by any Hospital and Medical Staff policies and rules applicable generally and any applicable to the particular situation. (2) Any restriction on the clinical privileges granted to me is waived in an emergency situation and such situation my actions are governed by the applicable section of the LSUHSCH-S Bylaws of the Medical Staff and the Laws of the State of Louisiana. __________________________________________________________________ Applicant's Signature / Date ====================================================================== *** FOR HOSPITAL USE ONLY *** DEPARTMENTAL: We have reviewed the delineation of clinical privileges and make the following recommendations: ( ) Approved as Requested ( ) Denied ( ) Approved with Conditions/Modifications ( ) Approved for Consultation only Conditions/Modifications: ________________________________________________ ______________________________________________________________________ ______________________________________________________ Signature of Department Chairman / Date ______________________________________________________ Signature of Policy Committee Member / Date ______________________________________________________ Signature of Policy Committee Member / Date CREDENTIALS COMMITTEE: We have reviewed the delineation of clinical privileges and make the following recommendations: ( ) Approved as Requested ( ) Denied ( ) Approved with Conditions/Modifications ( ) Approved for Consultation only Conditions/Modifications: ________________________________________________ ______________________________________________________________________ ______________________________________________________ Signature of Credentials Representative / Date ______________________________________________________ Signature of Credentials Representative / Date ______________________________________________________ Signature of Credentials Representative / Date |
Radiology
| 000.4 | PROCEDURES | |
| 9000 | A | Skull |
| 9000.1 | A | Sinus, mastoids, and mandibles |
| 9001 | A | Conscious Sedation **(Kyphoplasty) |
| 9003 | A | Extremities |
| 9004 | A | Spine |
| 9005 | A | Pelvis |
| 9006 | A | Ribs |
| 9008 | A | KUB and Abdomen |
| 9009 | A | IVP |
| 9010 | A | Retrograde Pyelogram |
| 9011 | A | Cystogram |
| 9012 | A | Urethrogram |
| 9013 | A | Pelvimetry Studies |
| 9014 | N | |
| 9015 | A | Retrograde Pyelography |
| 9016 | A | Static Cystogram |
| 9017 | N | Cine Cystourethrogram |
| 9018 | A | Urethrogram |
| 9019 | N | Triple Contrast Cystogram |
| 9020 | A | Antegrade Pyelography via percutaneous translumbar needle |
| 9021 | A | Voiding Cystourethrogram |
| 9022 | A | GI Series |
| 9023 | A | Barium Enema |
| 9024 | A | Double contrast Barium Enema |
| 9025 | A | Barium Swallow |
| 9026 | A | Double contrast GI series Pharmaco-enhanced with insufflation of air via tubes |
| 9027 | A | Retrograde Small Bowel Series |
| 9028 | A | Bronchogram |
| 9029 | A | Transcricoid percutaneous bronchography |
| 9030 | A | Selective bronchography via tubes |
| 9031 | A | Thyroid scans |
| 9032 | N | Brain scans |
| 9033 | A | Lung Scan (V/Q) |
| 9034 | A | Parathyroid Scans |
| 9035 | A | Liver Scans |
| 9036 | A | Bone Scans |
| 9037 | A | Kidney Scans |
| 9038 | A | Lymph node scans |
| 9039 | A | Joint Scans |
| 9040 | A | Cystogram scans |
| 9041 | A | Spleen scans |
| 9042 | A | Thyroid uptake |
| 9043 | A | Dacrocystogram |
| 9044 | A | T-3, T-4, T-7 |
| 9045 | A | Schilling test |
| 9046 | A | Blood Volume |
| 9047 | N | Red Cell survival |
| 9048 | N | Perchlorate washout |
| 9049 | N | Plasma volume |
| 9050 | N | Salivary Gland Scans |
| 9051 | A | Gallium Scan |
| 9052 | A | Gastric Emptying Scans |
| 9053 | A | Indium WBC Scan |
| 9054 | A | Bone Density Scan |
| 9055 | N | Thallium Heart Scan (MIBI) |
| 9056 | N | Gated Blood Pool (Heart) |
| 9057 | N | Thyroid Therapy with I-131 |
| 9058 | N | Cisternography (In-111) |
| 9059 | N | Bone Marrow |
| 9060 | A | Testicular Scan |
| 9061 | A | G.I. Bleed Scan |
| 9062 | N | Sr-89 |
| 9063 | N | P-32 |
| 9064 | N | Oncoscient In-111 |
| 9065 | A | 4 vessel angiography, Seldinger technique, transfemoral route |
| 9066 | A | 4 vessel angiography, Seldinger technique, transaxillary route |
| 9067 | A | Selective external carotid angiography, Seldinger technique |
| 9068 | A | Infarct angiography for control of AV aneurysm |
| 9069 | A | Brachiocephalics |
| 9070 | A | Selective thyroid angiography |
| 9071 | A | Thoracic outlet angiography via transfemoral route |
| 9072 | A | Aortography via transfemoral route |
| 9073 | A | Aortic arch aortography via axillary route |
| 9074 | A | Run-off femoral arteriography via needle technique |
| 9075 | A | Upper extremity run-off arteriography via needle technique |
| 9076 | A | Splenoportography via splenic artery injection |
| 9077 | A | Venography, lower extremities |
| 9078 | A | Venography, hepatic via, transfemoral approach |
| 9079 | A | Placement of Greenfield filter, IVC |
| 9080 | A | Pelvic organs via trans-femoral |
| 9081 | A | Pelvic organs via trans-axillary |
| 9082 | A | Run-off aortography |
| 9083 | A | Run-off femoral arteriography via catheter technique |
| 9084 | A | Arthrogram, shoulder |
| 9085 | A | Arthrogram, elbow |
| 9086 | A | Arthrogram, knee |
| 9087 | A | Arthrogram, small joints, forefoot |
| 9088 | A | Percutaneous transhepatic cholangiogram |
| 9089 | A | Stone removal with wire basket, percutaneous through T tube |
| 9090 | A | Sectional polytomography, computer assisted |
| 9091 | A | Bronchial arteriography via transfemoral route |
| 9092 | A | Abdominal arteriography via transfemoral route |
| 9093 | A | Abdominal arteriography via transaxillary route |
| 9094 | A | Selective angiography via transfemoral route |
| 9095 | A | Hepatic arteriography |
| 9096 | A | Splenic arteriography |
| 9097 | A | Renal arteriography |
| 9098 | A | Adrenal arteriography |
| 9099 | A | Superior mesenteric arteriography |
| 9100 | A | Pancreatico-duodenal arteriography |
| 9101 | A | Left gastric arteriography |
| 9102 | A | Inferior mesenteric arteriography |
| 9103 | N | |
| 9104 | A | |
| 9105 | A | |
| 9106 | A | |
| 9107 | A | |
| 9108 | A | |
| 9109 | A | |
| 9110 | A | Superior venacavagram |
| 9111 | A | Angioplasty - PTA arterial/venous |
| 9112 | A | TIPSS |
| 9113 | A | Stents - arterial/venous |
| 9114 | A | Thrombolysis - arterial/venous |
| 9115 | A | Atherectomy |
| 9116 | A | Foreign body retrieval |
| 9117 | N | Uterine artery embolization |
| 9118 | A | Biliary drainage - internal/external (with or without dilation & stent placement) |
| 9119 | A | Subselective catherization for chemotherapy |
| 9120 | A | Fistulogram - diagnostic |
| 9121 | A | Fistulogram - intervention (angioplasty/thrombolysis) |
| 9122 | A | Trans-arterial infarct implantation for inferior mesenteric bed |
| 9122 | A | Trans-arterial infarct implantation for inferior mesenteric bed |
| 9123 | A | Trans-femoral pelvic angiography |
| 9124 | A | |
| 9125 | A | |
| 9126 | A | |
| 9127 | A | Venography, upper extremities |
| 9128 | A | Venography, adrenal vein, transfemoral approach |
| 9129 | A | Mesenteric veins venography, transfemoral approach |
| 9130 | A | Pulmonary angiogram |
| 9130.1 | A | Vascular stents and stent grafts including aorta |
| 9130.2 | A | Vertebroplasty |
| 9130.3 | A | Kyphoplasty |
| 9130.6 | A | Tumor ablation |
| 9130.7 | A | Embolization of tumors |
| 9130.8 | A | Percutaneous discectomy |
| 9131 | N | Superficial therapy |
| 9132 | N | Orthovoltage therapy |
| 9133 | N | Megavoltage therapy |
| 9134 | N | Cobalt teletherapy |
| 9135 | N | Radioactive needle implantation |
| 9136 | N | Intracavitary application and implants |
| 9137 | N | Radioactive seed implants |
| 9138 | N | Strontium 90 therapy |
| 9139 | N | Electron beam therapy |
| 9140 | N | Neutron beam therapy |
| 9141 | N | Hyperthermia |
| 9142 | A | Cyst puncture aspiration with fluoroscopy |
| 9143 | A | Cyst puncture and aspiration under ultrasound control |
| 9144 | A | Bladder centesis under ultrasound control |
| 9145 | A | Antegrade pyelography under fluoroscopic |
| 9146 | A | Antegrade pyelography under ultrasound control |
| 9147 | A | Fluoroscopically guided biopsy lung |
| 9148 | A | Fluoroscopically guided biopsy bone |
| 9149 | A | Fluoroscopically guided biopsy liver |
| 9150 | A | Fluoroscopically guided biopsy kidney |
| 9151 | A | US guided thoracentesis |
| 9152 | A | US guided percutaneous drainage of abscess cavities |
| 9153 | A | US guided - drainage of biliary system |
| 9154 | A | US guided liver biopsy |
| 9155 | A | US guided kidney biopsy |
| 9156 | A | US guided biopsy of superfician soft tissues |
| 9157 | A | Zygography via injection bone marrow |
| 9158 | A | CAT head |
| 9159 | A | CAT orbit |
| 9160 | A | CAT face |
| 9161 | A | CAT sella/brain |
| 9162 | A | CAT heart |
| 9163 | A | CAT lung |
| 9164 | A | CAT chest |
| 9165 | A | CAT abdomen |
| 9166 | A | CAT liver/spleen |
| 9167 | A | CAT pancreas |
| 9168 | A | CAT kidney |
| 9169 | A | CAT pelvis |
| 9170 | A | CAT acetabulum |
| 9171 | A | CAT bladder |
| 9172 | A | CAT spine |
| 9173 | A | CAT upper extremity |
| 9174 | A | CAT biopsy |
| 9175 | A | CAT lower extremity |
| 9176 | A | CAT sinus |
| 9176.1 | A | Angiogram |
| 9176.2 | A | 3-D rectonstruction(vascular and non vascular) |
| 9177 | N | Water soluble positive contrast medium ventriculography |
| 9178 | N | Pantopaque cisternography via lumbar approach |
| 9179 | N | *Infarct implantation, AV malformation |
| 9180 | N | Myelogram, cervical |
| 9181 | N | Myelogram, thoracic |
| 9182 | N | Myelogram, lumbar |
| 9183 | N | Gas Myelogram |
| 9184 | N | Dacrocystograms |
| 9185 | N | Sialograms |
| 9186 | N | Polytomography, inner ear |
| 9187 | A | Abdomen |
| 9188 | A | Gallbladder |
| 9189 | A | Liver |
| 9190 | A | Aorta |
| 9191 | A | Adrenals |
| 9192 | A | Bladder |
| 9193 | A | Liver transplant |
| 9194 | A | Obstetrics/Gynecology |
| 9195 | A | Organ localization |
| 9196 | A | Thyroid |
| 9197 | A | Pelvis |
| 9198 | A | Aspiration biopsy |
| 9199 | A | Renal transplant |
| 9200 | A | Renal |
| 9201 | A | Cyst puncture localization |
| 9202 | A | Inferior vena cava |
| 9203 | A | Breast |
| 9204 | A | Extremity |
| 9205 | A | Amniocentesis localization |
| 9206 | A | Placental localization |
| 9207 | A | IUD localization |
| 9208 | A | Ventricles |
| 9209 | A | Doppler (Arterial and venous studies) |
| 9210 | A | Intraperitoneal |
| 9211 | A | Prostate |
| 9212 | A | Pyloric stenosis |
| 9213 | A | Growth monitoring |
| 9214 | A | Testes/Scrotum |
| 9215 | A | Hyperemia |
| 9216 | A | Transcranial |
| 9217 | A | Thoracic outlet |
| 9218 | A | Segmental pressures with continuous wave Doppler |
| 9219 | N | Head |
| 9220 | N | Abdomen |
| 9221 | N | Cardiac |
| 9222 | N | Musculoskeletal |
| 9223 | N | Spine |
Surgery
| 5012 | A | Incision/Excision |
| 5016.5 | A | BREAST |
| 5052 | A | Anastomosis of Ureter |
| 5053 | A | Repair Cystotomy |
| 5053 | A | Repair Cystotomy |
| 5093 | A | Cryotherapy |
| 5096 | A | Lymph Node - Excision |
| 5277 | A | |
| 5306 | A | |
| 5386 | A | |
| 5435 | A | |
| 5441 | A | |
| 5443 | A | |
| 5449 | A | |
| 5454 | A | |
| 5479 | A | |
| 9001 | A |