Get Sma Imaging Order Form For Bone Density (dexa Scan)

Filling out the SMA Imaging Order Form for Bone Density (DEXA Scan) online is a straightforward process that ensures you provide all necessary information for your imaging services. This guide will help you navigate each section of the form step by step, ensuring accuracy and completeness.

Follow the steps to fill out the SMA Imaging Order Form online.

1. Press the ‘Get Form’ button to obtain the SMA Imaging Order Form and open it in your preferred online editor.
2. Begin by filling in the patient's name in the designated field. Ensure the spelling is accurate to avoid any issues during the appointment.
3. Enter the date of birth for the patient. This information is critical for verifying age-related recommendations.
4. Provide the patient's phone number in the corresponding field to facilitate communication.
5. Include the patient's member number and SMA MRN for identification purposes within the medical system.
6. Specify the requesting provider's name, address, and phone number to ensure the order is processed correctly.
7. If applicable, enter the name of the CC provider along with a contact person for additional communication.
8. Input the diagnosis and any clinical information as required. This assists in ensuring the correct procedures are performed.
9. Include the ICD9 code(s) associated with the diagnosis to further detail the medical necessity of the scan.
10. Select how you wish to receive the report by indicating whether you prefer a call, fax, or other methods, and provide the necessary contact information.
11. Fill in any other or special instructions that may be relevant for the imaging services.
12. Review the completed form for accuracy, ensuring all fields are filled out completely.
13. Finalize your document by saving changes, downloading, printing, or sharing the form as needed.

Complete your SMA Imaging Order Form for Bone Density (DEXA Scan) online today to ensure timely processing of your imaging needs.