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How to fill out the Form 140 Master Diagnosis Sheet.doc online
The Form 140 Master Diagnosis Sheet is an essential document used for recording and summarizing a patient's diagnoses. This guide will walk you through a clear and user-friendly process to fill out the form online, ensuring accuracy and efficiency in your documentation.
Follow the steps to complete the Form 140 Master Diagnosis Sheet online.
- Click the ‘Get Form’ button to obtain the form and access it in your editing interface.
- Begin by entering the patient’s name in the designated field provided at the top of the form.
- Input the patient's identification number (Patient #) in the appropriate field below the name.
- Review the Master Diagnosis Sheet section. Here, you will see a list of codes associated with various diagnoses. Select the relevant codes that apply to the patient’s condition by placing a checkmark or entering them in the provided spaces.
- Continue through the subsequent sections, selecting or entering other pertinent diagnostic codes, ensuring each code accurately reflects the patient’s diagnosis.
- Fill out any additional codes under the categories like Cardio-Pulmonary, ENT, GI/GU, and General/Internal, if applicable.
- Lastly, ensure all fields are filled correctly. You have the option to save your changes, download the filled document, print it, or share it as needed.
Start filling out your Form 140 Master Diagnosis Sheet online today for a streamlined documentation experience.
Include the payment with Form 140. If you are expecting a refund or owe no tax, or owe tax but are not sending a payment, mail to Arizona Department of Revenue, PO Box 52138, Phoenix, AZ 85072-2138.
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