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YAG Posterior Capsulotomy Referral Form Please fax this form to 812.424.3000, Attention Surgery Scheduling Surgeon: Dwight A. Silver, M.D. Thomas A. Drummer, M.D. Joseph L. Carr, M.D. Patient Name:

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How to fill out yag posterior capsulotomy referral

01

Obtain a referral form for yag posterior capsulotomy from the ophthalmologist.

02

Make sure to fill out all the required patient information on the form, such as name, date of birth, and contact information.

03

Include the reason for the referral, which may be due to visual disturbances caused by a posterior capsular opacification.

04

Specify any relevant medical history or eye conditions that may impact the procedure.

05

Send the completed referral form to the ophthalmologist for review and scheduling of the yag posterior capsulotomy procedure.

Who needs yag posterior capsulotomy referral?

01

Patients who have developed visual disturbances or decreased vision due to posterior capsular opacification may need a yag posterior capsulotomy referral.

02

Individuals who have undergone cataract surgery in the past and are experiencing visual issues related to posterior capsule opacification may also benefit from this procedure.

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What is yag posterior capsulotomy referral?

YAG posterior capsulotomy referral is a medical procedure that involves using a laser to treat a condition called posterior capsular opacification (PCO) after cataract surgery.

Who is required to file yag posterior capsulotomy referral?

The ophthalmologist or eye surgeon who performed the YAG posterior capsulotomy procedure is required to file the referral.

How to fill out yag posterior capsulotomy referral?

To fill out a YAG posterior capsulotomy referral, the physician needs to complete a form with details about the patient, procedure, and medical necessity.

What is the purpose of yag posterior capsulotomy referral?

The purpose of YAG posterior capsulotomy referral is to inform other healthcare providers about the treatment and ensure proper documentation for insurance purposes.

What information must be reported on yag posterior capsulotomy referral?

The referral must include the patient's name, date of birth, medical history, details of the YAG posterior capsulotomy procedure, and any relevant medical findings.

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