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Click ‘Get Form’ to open the pleurx catheter order form in the editor.
Begin with Section A, entering the patient's name, phone number, date of birth, sex, and address. Ensure all fields are filled accurately as this information is crucial for processing.
In Section B, specify the primary and secondary diagnoses by checking the appropriate boxes. Include ICD-10 codes where applicable and indicate the duration of need along with the start date.
Next, provide details regarding the frequency of use and quantity to be dispensed. Choose from options like 'Once per day' or 'Every other day' based on your requirements.
Complete Section C by having the physician attest to the information provided. The prescriber must sign and print their name along with their NPI number.
Finally, review all sections for completeness before submitting. Incomplete forms may delay processing.

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Is a PleurX catheter indwelling?

What is an indwelling pleural catheter (PleurX\u2122)? If the fluid in your pleural space keeps coming back (recurrent pleural effusion), your healthcare provider may want to place an indwelling pleural catheter, often called a PleurX\u2122. The PleurX\u2122 drains the extra fluid from within the pleural cavity.

What type of catheter is PleurX?

The PleurX catheter is a small-bore chest tube designed to remain in place for prolonged periods, through which drainage of pleural fluid can be performed easily on a daily or less frequent outpatient basis.

How much does a PleurX catheter cost?

Pleurx Drainage Kit with 1000mL Vacuum Bottle, includes gauze pads, alcohol pads, and pair of gloves. The primary component is a unique evacuated plastic bottle with drainage line....Description. QtyRetailYou Pay1 KIT$2,916.00$823 61 Login for Best Price

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What is in a PleurX drainage kit?

The kit contains a drainage line, with a roller clamp to control rate of drainage, a vacuum bottle, and a sterile procedure pack with gloves, valve cap, slide clamp, alcohol swabs and dressing supplies.

Is PleurX a chest tube?

A PleurX is like a chest tube except it is smaller and designed for use at home.

Who puts in PleurX catheters?

If you have fluid around one lung, your doctor will place a PleurX catheter on that side of your chest. If you have fluid around both lungs, your doctor will choose the best side for the catheter.

What kind of catheter is a PleurX catheter?

A PleurX drainage catheter is a thin, flexible tube that's placed in your chest to drain fluid from your pleural space. This can make it easier for you to breathe.

What type of catheter is PleurX?

The PleurX catheter is a small-bore chest tube designed to remain in place for prolonged periods, through which drainage of pleural fluid can be performed easily on a daily or less frequent outpatient basis.

Pleurx catheter order form 2025

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Is a PleurX catheter indwelling?

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What is in a PleurX drainage kit?

Is PleurX a chest tube?

Who puts in PleurX catheters?

What kind of catheter is a PleurX catheter?

What type of catheter is PleurX?

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