Get the free oncotype dx order form

Ecotype DX Requisition Form Genomic Health, Inc. 301 Penobscot Drive Redwood City, CA 94063 USA Tel (866) ECOTYPE (866) 6626897 www.oncotypeDX.com Fax (866) 4440640 FORM INSTRUCTIONS: SECTION I V:

How to fill out oncotype dx order form

How to fill out oncotype dx order form:

1. Start by entering the patient's personal information, including their name, date of birth, and contact details.
2. Provide the patient's medical history, including their diagnosis and any relevant pathology reports.
3. Indicate the treating physician's information, including their name, specialty, and contact information.
4. Specify the type of specimen being submitted for testing, such as tumor tissue or lymph node tissue.
5. Include information about previous treatments the patient has received, such as surgery, chemotherapy, or radiation therapy.
6. Specify any additional tests requested, such as hormone receptor status or HER2 status.
7. Provide insurance information, including the name of the insurance company and the policy number.
8. If necessary, include any additional notes or instructions for the laboratory.
9. Finally, review the completed form for accuracy and sign it according to the designated section.

Who needs oncotype dx order form:

1. Patients who have been diagnosed with breast cancer and are considering treatment options.
2. Physicians or oncologists who require genomic testing information to make informed treatment decisions.
3. Laboratories or medical facilities responsible for conducting the oncotype dx test and interpreting the results.

People Also Ask about

How much does Oncotype DX cost?

The Oncotype DX test costs about $4,000.

Is Oncotype DX covered by insurance?

Is the Test Covered by Insurance? The Oncotype DX test is covered by Medicare and by most private insurance companies.

Is Oncotype DX covered by Medicare?

The Oncotype® and OncoExTra™ tests are covered by Medicare and many commercial insurance plans and available to patients who are enrolled in a Medicaid program.

What oncotype score requires chemo?

The Oncotype DX test is used to assign each women's cancer a score for recurrence risk on a scale of 0‒100. Women in the TAILORx trial with a high recurrence score on the test (26 and above) were assigned to receive chemotherapy and hormone therapy after surgery.

How do you order Oncotype DX?

We make your ordering experience efficient 1Register for our online physician portal. Register for our online physician portal by contacting Customer Service at +1 866-ONCOTYPE (+1 866-662-6897) or email us with your information. 2Complete an order form. 3Submit a sample. 4Access Results.

Who qualifies for oncotype testing?

2. Who is Oncotype DX for? The test is suitable for people recently diagnosed with early stage invasive breast cancer that: Has not spread to the lymph nodes under the arm.

How much does Oncotype DX test cost?

Table 3 ItemMean cost (USD)Oncotype DX test5141Endocrine therapy (years 1–5)256.5Endocrine therapy (years 6–8)289.6Chemotherapy14362 more rows • Jul 1, 2019

Does Medicare pay for Oncotype DX?

Insurance Coverage The Oncotype® and OncoExTra™ tests are covered by Medicare and many commercial insurance plans and available to patients who are enrolled in a Medicaid program.

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What is oncotype dx order form?

The Oncotype DX order form is a document used by healthcare providers to request genomic testing for patients with certain types of cancer, particularly early-stage breast cancer. It facilitates the collection of necessary clinical information required to perform the Oncotype DX test.

Who is required to file oncotype dx order form?

Healthcare providers, such as oncologists and pathologists, are required to file the Oncotype DX order form on behalf of their patients when they determine that genomic testing is necessary for treatment decisions.

How to fill out oncotype dx order form?

To fill out the Oncotype DX order form, healthcare providers need to provide patient demographics, clinical history, tumor information, and the specific tests being requested. Detailed instructions are usually provided on the form itself.

What is the purpose of oncotype dx order form?

The purpose of the Oncotype DX order form is to ensure that all relevant patient and tumor information is collected, which is crucial for accurate test results and informed treatment decisions based on the Oncotype DX score.

What information must be reported on oncotype dx order form?

The Oncotype DX order form must report patient identification details, clinical stage of cancer, tumor pathology information, hormone receptor status, and any other relevant medical history that may affect test interpretation.