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Tructions: The purpose of this form is to provide key HRIF program visit information required by the CCS Program or Regional Office for ongoing case management purposes. In addition to submitting this form to the CCS Program or Regional Office, a copy of this information is also to be submitted to the child s pediatric primary care provider or medical home, NICU medical director (if the director is not the HRIF program medical director) and other providers involved in the care of the child*. T.

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Related content

HRIF Team Visit Report Form
This form contains elements required by CCS for case management. Please attach copies of...
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HRIF Frequently Asked Questions
At each visit, there will be some assessment of your child's development. We might use...
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Department of Health Services - DHCS
2006 · Cited by 3 — A HRIF. Program can either use a template HRIF Team Visit Report...
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The complexity and length of time spent determine the code billed. Nurse Specialist Z4300 For non-physician coordinating activities for the SCC per patient per date of service (including coordinating team case conference discussion and recommendations after team member evaluations and case reporting).

California's High Risk Infant Follow-up (HRIF) Program, run by California Children's Services (CCS) division, oversees outpatient “follow-up” of infants requiring additional developmental care after discharge from the NICU through local HRIF clinics.

CPT® code 63655 - 1 permanent spinal cord stimulator per patient per lifetime and must be performed in an ASC, outpatient hospital or hospital.

Some examples common CPT codes used by chiropractors include: CPT Code 99203 – Initial Exam. CPT Code 98940 - Chiropractic manipulative treatment (CMT); spinal, 1-2 regions. CPT Code 97110 – Therapeutic Exercise.

A. ing to the American Medical Association (AMA) and the American College of Radiology (ACR), you would assign CPT code 76604–52 for this service.

CPT® code 64582 - Insertion of hypoglossal nerve stimulator electrode and generator and breathing sensor electrode.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232