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This form is used for requisitioning muscle biopsy specimens at The Children’s Hospital of Philadelphia, detailing patient and provider information, specimen details, and billing information.
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How to fill out muscle biopsy requisition
How to fill out muscle biopsy requisition
01
Obtain a muscle biopsy requisition form from the laboratory or healthcare provider.
02
Fill in the patient's personal information, including full name, date of birth, and contact details.
03
Provide the patient's medical history relevant to the muscle complaint.
04
Indicate the specific muscle(s) to be biopsied and the reason for the biopsy.
05
Include any relevant diagnostic codes or clinical information.
06
Sign and date the requisition form to validate it.
07
Submit the completed requisition form along with the muscle biopsy sample to the laboratory.
Who needs muscle biopsy requisition?
01
Patients presenting with unexplained muscle weakness or muscle pain.
02
Individuals suspected of having muscular dystrophies or other neuromuscular disorders.
03
Patients with unexplained elevated levels of creatine kinase (CK) in blood tests.
04
Individuals with a family history of genetic muscle disorders.
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What is muscle biopsy requisition?
A muscle biopsy requisition is a formal request form used by healthcare providers to obtain a sample of muscle tissue for diagnostic analysis.
Who is required to file muscle biopsy requisition?
Typically, a muscle biopsy requisition must be filed by a licensed healthcare professional, such as a physician or a specialist who is overseeing the patient's care.
How to fill out muscle biopsy requisition?
To fill out a muscle biopsy requisition, the healthcare provider must complete patient identification details, the specific site for the biopsy, relevant medical history, and any specific tests or analyses required.
What is the purpose of muscle biopsy requisition?
The purpose of a muscle biopsy requisition is to facilitate the collection of muscle tissue samples for laboratory evaluation, helping to diagnose various muscle disorders or conditions.
What information must be reported on muscle biopsy requisition?
The information that must be reported on a muscle biopsy requisition includes the patient's name, date of birth, medical record number, reason for the biopsy, site of the biopsy, physician's name, and any specific tests requested.
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