Get the free REFERRAL/ORDER FOR Vertebroplasty or Kyphoplasty - oakwood

This document is used to refer a patient for Vertebroplasty or Kyphoplasty procedures, detailing patient information, the ordering physician, insurance details, and specific medical indications required

How to fill out referralorder for vertebroplasty or

How to fill out REFERRAL/ORDER FOR Vertebroplasty or Kyphoplasty

1. Identify the patient needing vertebroplasty or kyphoplasty.
2. Gather the patient's medical history and current symptoms.
3. Perform necessary imaging studies (e.g., X-rays, MRI) to confirm the need for the procedure.
4. Complete the referral/order form with patient details including name, age, and insurance information.
5. Provide documentation of conservative treatment attempts and their outcomes.
6. Indicate the specific procedure recommended (vertebroplasty or kyphoplasty).
7. Include the referring physician’s name, contact information, and signature.
8. Submit the referral/order form to the appropriate specialist or facility.

Who needs REFERRAL/ORDER FOR Vertebroplasty or Kyphoplasty?

1. Patients with osteoporotic fractures causing back pain.
2. Individuals suffering from tumors affecting spinal stability.
3. Patients experiencing severe pain and disability due to vertebral compression fractures.
4. Individuals who have not responded to conservative treatment options.

People Also Ask about

When to refer for kyphoplasty?

These are some reasons your doctor may recommend kyphoplasty or vertebroplasty for you: You have compression fractures of the spine. You have experienced severe, disabling pain for more than two months. Your pain doesn't go away with conservative treatments (rest, pain medications and physical therapy)

Who is eligible for vertebroplasty?

You may be a candidate for vertebroplasty if you have severe pain caused by a compression fracture. This pain lasts for at least two months and doesn't get better with other forms of treatment like rest, medications and physical therapy.

Who qualifies for vertebroplasty?

Individuals with severe osteoporosis may require a vertebroplasty to correct the structural instability of a weakened spine. During a minimally invasive vertebroplasty, your surgeon will use a large needle to enter through the posterior of the torso.

What should the platelet count be for vertebroplasty?

General Tenets/Contraindications The platelet count should be at least 100,000 at the time of the procedure. Sepsis is a contraindication, as is active infection. We recommend waiting at least 2 weeks after treatment of an infection to minimize infectious risks.

Who is a candidate for vertebroplasty?

You may be a good candidate for vertebroplasty if other treatments have failed and your fractured vertebra is causing severe pain, immobility, or more serious complications. Vertebroplasty is an outpatient procedure (meaning an overnight hospital stay is usually not required).

When to consider vertebroplasty?

Candidates for vertebroplasty typically have severe, persistent back pain due to a spinal compression fracture that has not responded to nonsurgical treatments.

Which is better vertebroplasty or kyphoplasty?

Compared with medical therapy, kyphoplasty was superior for improving both pain and patient function, whereas vertebroplasty improved patient function but not pain.

For pdfFiller’s FAQs

What is REFERRAL/ORDER FOR Vertebroplasty or Kyphoplasty?

A REFERRAL/ORDER FOR Vertebroplasty or Kyphoplasty is a formal request from a healthcare provider authorizing the performance of these minimally invasive procedures to treat spinal fractures, typically caused by osteoporosis or trauma.

Who is required to file REFERRAL/ORDER FOR Vertebroplasty or Kyphoplasty?

Typically, a licensed physician or qualified healthcare provider who evaluates the patient's condition and determines the need for the procedure is required to file the REFERRAL/ORDER.

How to fill out REFERRAL/ORDER FOR Vertebroplasty or Kyphoplasty?

To fill out the REFERRAL/ORDER, the healthcare provider must include patient information, diagnosis, specific procedure requested, relevant medical history, and any necessary imaging studies or evaluations.

What is the purpose of REFERRAL/ORDER FOR Vertebroplasty or Kyphoplasty?

The purpose of the REFERRAL/ORDER is to ensure that the patient receives the appropriate procedure for their medical condition, to document the medical necessity, and to facilitate the scheduling and insurance authorization process.

What information must be reported on REFERRAL/ORDER FOR Vertebroplasty or Kyphoplasty?

The information that must be reported includes patient demographic details, clinical diagnosis, procedure details, medical history, indications for the procedure, and physician's signature.