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Get Surgery Block Scheduling Forms 2004-2024

Code Diagnosis ICD9 Code #1 SACROSPINOUS LIGAMENT FIXATION 57282 VAGINAL VAULT PROLAPSE 618.5 #2 COMBINED ANTERIOR AND POSTERIOR COLPORRHAPHY WITH ENTEROCELE REPAIR 57265 CYSTOCELE & RECTOCELE 618.0 #3 #4 PREFERENCES: Assistant: SCHEDULED: CNRFA Assistant: Date Preferred: Time Needed: Date of Surgery: Facility: Thunderbird Facility: Patient Status: Same Day Admit Admission Date/Time: Anesthesia: 602-246-0041 Anesthesia: Labs within 10 days of admission: (lab to fax.

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