Get Lab Assignment 7-1 - Case Abstract Form - Delmar

This guide provides step-by-step instructions for accurately completing the Lab Assignment 7-1 - Case Abstract Form - Delmar online. Follow these guidelines to ensure that all required information is correctly entered.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to access the Lab Assignment 7-1 - Case Abstract Form - Delmar and open it in your editing environment.
2. In the first field labeled '01 Hospital Number,' enter the assigned hospital number for the patient.
3. Proceed to the '02 Patient Date of Birth' section. Use the provided input fields to enter the patient's birth month, day, and year (in YYYY format).
4. Next, select the patient's gender in '03 Patient Gender.' Choose from the options provided: Male, Female, Other, or Unknown.
5. In '04A Race,' select the race of the patient by choosing from the available options, which include American Indian, Asian or Pacific Islander, Black, White, Other, or Unknown.
6. Fill out '05A Living Arrangement' by selecting how the patient is living, with choices such as Alone, With spouse, With children, and others.
7. Enter the admission date and hour in '07 Admission Date and Hour' using the specified format.
8. In '04B Ethnicity,' select the appropriate option regarding the patient's ethnic background.
9. For '05B Marital Status,' indicate the patient's marital status by selecting Married, Single, Divorced, Separated, or Unknown.
10. In '08 Type of Admission,' select if the admission was Scheduled or Unscheduled.
11. Fill out '09 Discharge Date and Time' with the date of discharge in the appropriate format.
12. Provide the '10 Attending Physician Number' in the corresponding field.
13. Enter the '11 Operating Physician Number' in the designated area.
14. In '12 Principal Diagnosis Code,' input the relevant ICD code.
15. Continue entering additional diagnosis codes in '13 Other Diagnosis Code(s)' and provide qualifiers in '14 Qualifiers for Other Diagnoses.'
16. Complete '15 External Cause of Injury Codes' as necessary, inputting up to three ICD E-codes.
17. Choose the appropriate disposition in '18 Disposition' reflecting where the patient was discharged.
18. Indicate the patient's expected payment source in '19 Patient’s Expected Payment Source' by selecting the relevant option.
19. Finally, provide the total charges in '20 Total Charges' indicating the financial factors involved.
20. Once all fields are filled in, save your changes, download, print, or share the completed form as needed.

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