Virtuox overnight oximetry order form 2025

1. Click ‘Get Form’ to open the virtuox overnight oximetry order form in the editor.
2. Begin by filling out the 'Patient Demographics' section. Enter the patient's name, sex, date of birth, and social security number. Ensure all information is accurate for proper processing.
3. Next, complete the 'Insurance Demographics' section. Provide details for up to two insurance payers, including payer names, ID numbers, group numbers, and contact phone numbers. Remember to fax copies of private insurance cards if applicable.
4. In the 'Diagnostic Orders' section, indicate whether awake oximetry or overnight oximetry is required. Specify any additional oxygen settings or devices used by checking the appropriate boxes.
5. Check all relevant ICD-9 codes that apply to the patient's condition from both respiratory and sleep-related categories. This ensures comprehensive documentation for billing purposes.
6. Finally, sign and date the form at the bottom to certify that you are ordering the necessary tests for the patient. Once completed, fax your order using the provided number.

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