ACHD Referral
When to Refer
Some ACHD patients require a one-time consultation or can be comanaged together with community providers. Patients with moderate or high complexity require more direct management at an ACHD center. The ACC/AHA Guidelines for the Care of Adults with Congenital Heart Disease recommend moderate to severe/highly complex patients be managed at an accredited center.
| Degree | Examples |
|---|---|
| Simple | atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA), pulmonary stenosis (mild), aortic stenosis |
| Moderate | coarctation of the aorta, Ebstein’s anomaly, moderate pulmonary stenosis, Tetralogy of Fallot (milder forms) |
| Severe/Highly Complex | hypoplastic left heart syndrome (HLHS), tricuspid atresia, transposition Complex of the great arteries (TGA), single ventricle disorders, any CHD causing cyanosis (low oxygen levels) |
Refer a Patient or Get in Touch
Please FAX the following to 424-465-6189:
- Face sheet
- Referral
- Clinical and surgical procedure notes with medication list
- All testing reports including ECG, Holter monitor, device interrogation (ICD/PM) (when applicable)
Please email the following imaging and reports:
- Echocardiograms
- Advanced imaging studies (TEE, MRI, CT)
We kindly request that actual imaging studies be sent prior to the patient’s appointment.
Health Plans & Health Insurance
At UCLA Health, we accept a wide range of health insurance plans to help you get the care you need. For the latest information on UCLA Health hospital and physician participation in insurance plan networks, please call our representatives at 310-301-8700 (Monday to Friday, 8 am to 5 pm).
View a list of UCLA Health accepted insurances.
If you are referring a patient who has HMO insurance or assigned Medi-Cal, the referring provider needs to get prior authorization before the patient can be scheduled. For the authorization, please include two things:
1. New patient consultation
2. Congenital echocardiogram
This approval is requested by the insurance plan. The clinic cannot schedule the patient’s appointment until both authorizations are received. If the referring provider needs help obtaining authorization or needs CPT codes to submit the request please email our ACHD Office.