Get Npt 4017 Generic Order Form - Apria Healthcare

Filling out the NPT 4017 Generic Order Form for Apria Healthcare is essential for initiating Negative Pressure Wound Therapy (NPWT). This comprehensive guide provides step-by-step instructions to assist users in accurately completing the online form, ensuring that all necessary information is provided for processing.

Follow the steps to complete the NPT 4017 Generic Order Form online.

1. Click the ‘Get Form’ button to retrieve the NPT 4017 Generic Order Form and open it in your preferred online editor.
2. Provide the patient information, including the patient's name, date of birth, and contact information. Ensure all entries are accurate to facilitate efficient processing.
3. In the negative pressure wound therapy documentation requirements section, confirm that all necessary documentation is prepared. This includes a detailed written order from the treating authorized prescriber, insurance information, and any applicable medical records.
4. Complete Section 1—Patient Order Information, which requires the diagnosis code, details of the NPWT prescription, and wound measurements. It is essential to clearly document the quantity and type of dressing kits and canister sets prescribed.
5. For Section 2—Patient Delivery and Follow-Up Care, indicate the requested delivery date and address, whether it is a hospital or home delivery. Specify the name of the home health agency or wound care clinic, if applicable.
6. Review the common ICD-9 codes listed to determine which codes are relevant for your order. Ensure that you select the appropriate codes for coverage.
7. Before finalizing, ensure that all required fields are filled in accurately, then save the changes. You may choose to download, print, or share the completed form as needed.

Complete your order forms online to ensure a smooth processing experience.