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This form is used to assess the risk of tuberculosis exposure in patients, documenting prior exposure history and recommending testing based on the collected information.

How to fill out interim tuberculosis exposure risk

How to fill out INTERIM TUBERCULOSIS EXPOSURE RISK ASSESSMENT

1. Begin by gathering all necessary personal information including name, date of birth, and contact details.
2. Review the criteria for potential exposure to tuberculosis, which may include recent travel, contact with infected individuals, or symptoms experienced.
3. Complete the section on health history, detailing any previous history of tuberculosis or related health issues.
4. Fill out the risk factors section by identifying any relevant factors such as immunocompromised status or living in high-risk environments.
5. Answer the symptom questionnaire honestly, indicating any current symptoms such as cough, weight loss, or fever.
6. Review the entire assessment for accuracy and completeness before submitting.
7. Submit the form to the designated health authority or department for evaluation.

Who needs INTERIM TUBERCULOSIS EXPOSURE RISK ASSESSMENT?

1. Individuals who have had potential exposure to tuberculosis.
2. Healthcare workers who may come into contact with TB patients.
3. People with symptoms suggestive of tuberculosis.
4. Individuals living in or traveling to high-risk areas for tuberculosis.
5. Those with compromised immune systems that increase the risk of TB infection.

People Also Ask about

What is the ICD 10 code for TB risk assessment?

Who may administer the TB risk assessment? Per California Education and Health and Safety Codes, the TB risk assessment is to be administered by a health care provider. The risk assessment should be administered face-to-face.

What is diagnosis code Z11 7?

ICD-10 Code for Latent tuberculosis- Z22. 7- Codify by AAPC.

What is a tuberculosis risk assessment?

For a healthy person to be infected with the TB bacteria, they generally must have prolonged close exposure to someone with active TB, for example a family member living in the same house (i.e. greater than 8 hours a day for several months).

What is the ICD-10 code for z227?

Z13. 83 - Encounter for screening for respiratory disorder NEC | ICD-10-CM.

What is the ICD-10 code for TB risk?

Z20. 1 - Contact with and (suspected) exposure to tuberculosis | ICD-10-CM.

For pdfFiller’s FAQs

What is INTERIM TUBERCULOSIS EXPOSURE RISK ASSESSMENT?

The INTERIM TUBERCULOSIS EXPOSURE RISK ASSESSMENT is a tool used to evaluate and document the risk of tuberculosis exposure in individuals, especially in environments where there may be higher chances of transmission.

Who is required to file INTERIM TUBERCULOSIS EXPOSURE RISK ASSESSMENT?

Healthcare providers, employers in high-risk settings, and public health officials may be required to file the INTERIM TUBERCULOSIS EXPOSURE RISK ASSESSMENT for individuals who have been potentially exposed to tuberculosis.

How to fill out INTERIM TUBERCULOSIS EXPOSURE RISK ASSESSMENT?

To fill out the INTERIM TUBERCULOSIS EXPOSURE RISK ASSESSMENT form, one should provide detailed information regarding the individual exposed, the circumstances of exposure, potential symptoms, and previous tuberculosis history.

What is the purpose of INTERIM TUBERCULOSIS EXPOSURE RISK ASSESSMENT?

The purpose of the INTERIM TUBERCULOSIS EXPOSURE RISK ASSESSMENT is to identify individuals at risk for tuberculosis infection or disease in order to implement appropriate follow-up measures and treatments.

What information must be reported on INTERIM TUBERCULOSIS EXPOSURE RISK ASSESSMENT?

The information that must be reported includes the individual's demographic details, exposure history, clinical symptoms, risk factors, and the date of the potential exposure.