ARUP Laboratories Patient History Form for Non-Invasive Prenatal Testing (NIPT) 2019 free printable template

THISISNOTATESTREQUESTFORM. Pleasefilloutthisformandsubmititwiththetestrequestformorelectronicpackinglist.PATIENTHISTORYFORNONINVASIVEPRENATALTESTING(NIP) PatientNameDateofBirthOrderingProviderNPI×PhysicianPager/CellPracticeSpecialty GeneticCounselor DrawdatePhysicianPhone PhysicianFaxCounselorPhone Gestationalageatdrawlb/kg Patientscurrentweight

How to fill out ARUP Laboratories Patient History Form for Non-Invasive

How to fill out ARUP Laboratories Patient History Form for Non-Invasive Prenatal

1. Start with the patient's personal information: fill in the patient's name, date of birth, and contact information.
2. Indicate the patient's medical history: check any relevant medical conditions, surgeries, or genetic disorders.
3. Provide details on family history: list any known genetic conditions or significant health issues in the family.
4. Fill in obstetric history: record previous pregnancies, outcomes, complications, and any prenatal care received.
5. Complete the current pregnancy details: include the estimated due date, any ultrasounds or tests performed, and relevant symptoms.
6. Review and ensure all sections are filled accurately to avoid delays in processing.

Who needs ARUP Laboratories Patient History Form for Non-Invasive Prenatal?

1. Pregnant individuals seeking non-invasive prenatal testing to assess the risk of genetic conditions in the fetus.
2. Healthcare providers managing patients who require accurate prenatal screening and need patient history documentation.

People Also Ask about

How accurate is non-invasive prenatal testing NIPT?

NIPT is a highly accurate screen, however, it is not 100% accurate. It is not considered a diagnostic test (see What are my other options?). The detection rate is laboratory-dependent but is typically between 90-99% for high-risk, singleton (only one baby) pregnancies with false positive rates of less than 1%.

Is the NIPT test covered by insurance?

NIPT testing costs vary. Most health insurances cover most (if not all) of the cost. Many cover at least a portion. Check with your insurance provider before testing to be sure.

At what age is NIPT covered by insurance?

NIPT is considered medically necessary in the following circumstances: Maternal age or oocyte age of 35 years or older at delivery; or. Fetal ultrasound findings indicating an increased risk of aneuploidy; or. History of a prior pregnancy with a trisomy; or.

Is CVS the same as NIPT testing?

NIPT can also tell you whether you're having a boy or girl—often earlier than an ultrasound. Unlike traditional tests such as amniocentesis or chorionic villus sampling (CVS), NIPT does not require disturbing the placenta or amniotic fluid, which can slightly increase the risk of miscarriage.

How much is a NIPT test?

The cost of NIPT is $425 (screening for trisomy 21, 18 and 13).

How do I book a NIPT test?

Once you have received a completed NIPT request form from your doctor, you will need to book and pay for your NIPT. This can be done by using the Sonic Genetics payment portal.

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What is ARUP Laboratories Patient History Form for Non-Invasive Prenatal?

The ARUP Laboratories Patient History Form for Non-Invasive Prenatal is a document used to collect pertinent medical history and information from patients who are undergoing non-invasive prenatal testing.

Who is required to file ARUP Laboratories Patient History Form for Non-Invasive Prenatal?

Healthcare providers ordering non-invasive prenatal testing on behalf of their patients are required to file the ARUP Laboratories Patient History Form.

How to fill out ARUP Laboratories Patient History Form for Non-Invasive Prenatal?

To fill out the form, ensure all sections are completed, including patient demographics, relevant medical history, and any previous pregnancy complications, as well as any pertinent family history.

What is the purpose of ARUP Laboratories Patient History Form for Non-Invasive Prenatal?

The purpose of the form is to gather essential clinical information that aids in interpreting test results and assessing risks associated with the pregnancy.

What information must be reported on ARUP Laboratories Patient History Form for Non-Invasive Prenatal?

The form must report information such as patient details, previous pregnancy outcomes, family history of genetic disorders, maternal age, and any health conditions that may affect the pregnancy.