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Infusion Order FormFAX TO: 972.499.9210PATIENT INFORMATION Patient Name:DOB:Phone:Sex:MF Ht:Wt:lbskgAllergies:Primary Language: Patient Preferred Location: ICD 10 CODE REQUIREDDIAGNOSIS & CLINICAL
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Gather all necessary patient information
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Identify the main reason for the patient's visit or diagnosis
03
Consult the alphabetic index in the ICD-10-CM codebook to locate the main term
04
Follow any cross-references to find the correct code
05
Verify the code in the tabular list and confirm the specificity of the code

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The ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) guide is a standardized coding system used by healthcare providers to classify and code diagnoses, symptoms, and procedures. It is essential for medical billing, reporting, and statistical analysis.
Healthcare providers, including hospitals, physicians, and other practitioners who submit claims for health services, are required to file using the ICD-10-CM coding system.
To fill out the ICD-10-CM, providers must identify the patient’s condition, look up the relevant code in the ICD-10-CM coding book or database, and include that code on the claim form submitted to insurance companies or other payers.
The purpose of the ICD-10-CM guide is to provide a uniform system for coding medical diagnoses and procedures, facilitating accurate billing, enhancing healthcare research, and improving patient care by allowing for better tracking of health statistics.
The information that must be reported includes the specific diagnosis or condition, relevant codes, patient demographic information, and any other required details related to the medical services provided.
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