Get Pre-operative Pacemaker / Implantable Cardioverter Defibrillator Form
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How to fill out the Pre-Operative Pacemaker / Implantable Cardioverter Defibrillator Form online
Filling out the Pre-Operative Pacemaker / Implantable Cardioverter Defibrillator Form online is an essential step to ensure your surgical procedure goes smoothly. Follow this guide for a detailed walkthrough of each section of the form, making the process easier and more efficient.
Follow the steps to complete your form accurately and efficiently.
- Press the ‘Get Form’ button to access the form and open it in your document editor.
- In the first section, provide the patient's full name and date of birth. Ensure that the information is accurate, as this is crucial for identification during the surgical process.
- Next, enter the scheduled surgery date and the name of the physician performing the procedure. It is important to confirm these details with the healthcare provider if uncertain.
- Fill in the surgery or procedure being performed and estimate the length of the procedure. Clear and specific descriptions will facilitate effective communication among the medical team.
- In the cardiologist section, indicate the cardiologist’s name and phone number. This contact information is important for coordination and follow-up.
- Provide information regarding the pacemaker or implantable cardioverter-defibrillator model, including the number and serial number. This data is vital for device management.
- Record the baseline programming and underlying rhythm, along with the date the device was placed. This ensures that the medical team is aware of the patient's device history.
- Indicate the reason for the device being in place. Be clear and concise to prevent misunderstanding in the surgical context.
- Fill in the date of the last interrogation of the pacemaker or defibrillator, as this information helps to assess the current status of the device.
- In the perioperative recommendations section, check the appropriate responses as instructed. This may include the anticipated response to magnet usage and monitoring needs.
- If applicable, record the name and contact information of the pacemaker representative required for device reprogramming on the day of surgery.
- Lastly, include any additional information relevant to the patient’s medical condition or special requirements. This can provide crucial insights to the surgical team.
- Obtain the required signature from the medical doctor along with the date and time before submission.
- Once all sections are completed, save the changes, download the document, print it, and share it as necessary, ensuring that you keep a copy for your records.
Ready to complete your form online? Start now to ensure a smooth surgical experience.
The CPT code for the interrogation of an implantable cardioverter defibrillator is 93279. This code is essential for billing and tracking purposes related to device management and follow-up. Accurately documenting this code on the Pre-Operative Pacemaker / Implantable Cardioverter Defibrillator Form simplifies the workflow for healthcare providers and improves the quality of patient care.
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