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This document serves as a medical review form for low back pain office visits related to surgical evaluations within the HealthPartners network.
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How to fill out Spine Surgical Practice - Low Back Pain Office Visit Medical Review Form
01
Begin by entering the patient's personal information, including name, date of birth, and contact details.
02
Fill out the insurance information, providing the policy number and insurance provider details.
03
Indicate the reason for the visit, specifying symptoms related to low back pain.
04
Document the patient's medical history, including any previous treatments and surgeries related to back pain.
05
Record any current medications the patient is taking, including dosages and purpose.
06
Complete the physical examination findings, noting any relevant observations made during the examination.
07
Include diagnostic imaging results if available, such as X-rays or MRIs.
08
Indicate the treatment plan and any recommendations for further management.
09
Lastly, ensure the form is signed and dated by the healthcare provider.
Who needs Spine Surgical Practice - Low Back Pain Office Visit Medical Review Form?
01
Patients experiencing low back pain who require evaluation for surgical options.
02
Healthcare providers who need a structured format for documenting a low back pain office visit.
03
Insurance companies needing detailed information for processing claims related to low back pain treatments.
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People Also Ask about
What is the medical term used to describe lower back pain?
Back pain is also known as 'lumbago', which takes its name from the lumbar region of the spine.
What are the clinical practice guidelines for low back pain?
For acute LBP, the guidelines recommended the use of non-steroidal anti-inflammatory drugs (NSAIDs), therapeutic exercise, staying active, and spinal manipulation. For subacute LBP, the guidelines recommended the use of NSAIDs, therapeutic exercise, staying active, and spinal manipulation.
What is the gold standard treatment for lower back pain?
Physical Therapy remains the gold standard for the conservative treatment of low back pain due to its' clinical effectiveness and cost savings vs. other forms of treatment including usual care.
What are the recent clinical practice guidelines for the management of low back pain?
For acute LBP, the guidelines recommended the use of non-steroidal anti-inflammatory drugs (NSAIDs), therapeutic exercise, staying active, and spinal manipulation. For subacute LBP, the guidelines recommended the use of NSAIDs, therapeutic exercise, staying active, and spinal manipulation.
What is the spine procedure for back pain?
1:43 4:30 Pain. Third have the patient demonstrate a straight leg raise. Next have the patient demonstrate aMorePain. Third have the patient demonstrate a straight leg raise. Next have the patient demonstrate a cross straight leg raise. We will now demonstrate the motor deep tendon reflex.
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What is Spine Surgical Practice - Low Back Pain Office Visit Medical Review Form?
The Spine Surgical Practice - Low Back Pain Office Visit Medical Review Form is a document used to collect comprehensive medical information from patients experiencing low back pain, aimed at evaluating their condition and determining the appropriate treatment.
Who is required to file Spine Surgical Practice - Low Back Pain Office Visit Medical Review Form?
Patients who are seeking consultation or treatment for low back pain within a spine surgical practice are required to file the Spine Surgical Practice - Low Back Pain Office Visit Medical Review Form.
How to fill out Spine Surgical Practice - Low Back Pain Office Visit Medical Review Form?
To fill out the Spine Surgical Practice - Low Back Pain Office Visit Medical Review Form, patients should accurately provide their personal information, medical history, details about their low back pain, including symptoms, previous treatments, and any relevant imaging studies.
What is the purpose of Spine Surgical Practice - Low Back Pain Office Visit Medical Review Form?
The purpose of the Spine Surgical Practice - Low Back Pain Office Visit Medical Review Form is to gather necessary information that helps healthcare providers assess the patient's condition, formulate a diagnosis, and create an effective treatment plan.
What information must be reported on Spine Surgical Practice - Low Back Pain Office Visit Medical Review Form?
The information that must be reported on the form includes the patient's demographic details, medical history, specifics of their low back pain symptoms, previous treatments or surgeries, and results from any imaging studies related to their condition.
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