Get the free 57.114 Urinary Tract infection (UTI) form - cdc

Form Approved OMB No. 0920-0666 Exp. Date: 12/31/2017 www.cdc.gov/nhsn Urinary Tract infection (UTI) Page 1 of 4 *required for saving **required for completion Facility ID: *Patient ID: Secondary

How to fill out 57114 urinary tract infection

How to fill out 57114 urinary tract infection:

1. Begin by gathering all necessary information and documents related to the urinary tract infection. This may include medical records, test results, and any relevant history.
2. Ensure that all personal information, such as name, date of birth, and contact information, is accurately provided on the form.
3. The form may ask for details about the specific symptoms experienced, such as pain or discomfort during urination, frequent urges to urinate, or presence of blood in the urine. Provide as much detail as possible to help healthcare professionals accurately diagnose and treat the infection.
4. It is important to provide information about any medications currently being taken, including dosage and frequency. Include both prescription and over-the-counter medications as well as any supplements or herbal remedies.
5. If there have been any previous urinary tract infections or related complications, make sure to mention them on the form.
6. Take note of any relevant medical conditions, such as diabetes or kidney disease, as these can impact the treatment and management of a urinary tract infection.
7. Provide a detailed medical history, including any surgeries or procedures related to the urinary tract or reproductive system.
8. If the individual has recently traveled, especially to areas known for antibiotic resistance or unusual strains of bacteria, this information should be included on the form.
9. Review the completed form for accuracy and completeness before submitting it to the healthcare provider.

Who needs 57114 urinary tract infection:

1. Individuals who are experiencing symptoms of a urinary tract infection, such as pain or burning during urination, frequent urge to urinate, cloudy or discolored urine, or foul-smelling urine, may need to fill out the 57114 form.
2. Healthcare providers will also require the completion of this form for proper diagnosis and treatment of urinary tract infections.
3. This form may be needed for patients of all ages, including children, adults, and older adults.

Overall, filling out the 57114 urinary tract infection form accurately and thoroughly is crucial to ensure proper diagnosis and treatment. It helps healthcare providers gather necessary information to develop an appropriate treatment plan and prevent further complications.

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What is 57114 urinary tract infection?

57114 urinary tract infection is a specific medical code used to report cases of urinary tract infections.

Who is required to file 57114 urinary tract infection?

Healthcare providers and facilities are required to file 57114 urinary tract infection when diagnosing and treating patients with this condition.

How to fill out 57114 urinary tract infection?

To fill out 57114 urinary tract infection, healthcare providers must document relevant information about the patient's diagnosis, treatment, and outcomes.

What is the purpose of 57114 urinary tract infection?

The purpose of 57114 urinary tract infection is to track and monitor cases of urinary tract infections for public health and research purposes.

What information must be reported on 57114 urinary tract infection?

Information such as the patient's demographics, medical history, symptoms, treatment provided, and any complications must be reported on 57114 urinary tract infection.