Prescriptions
Rx Acyclovir (pdf)
Rx Anoheal (pdf) 6-19
Rx Ambien (pdf)
Rx Amitiza
Rx Analpram HC (pdf) 8-17

Rx Apriso (pdf)

Rx Asacol (pdf)
Rx Ativan (pdf)
Rx Antifungal (pdf)
Rx Anusol Sup ... (pdf)
Rx Augmentin (pdf)
Rx Bactrim DS (pdf)

Bentyl (pdf)

Rx Capsaicin (pdf)
Rx Cipro (pdf)
Rx Diflucan (pdf)
Rx Dilaudid (pdf)
Rx Dexilant​

Rx Exparel (pdf)
Rx Flagyl (pdf)
Rx H Pylori

Rx Imiquimod (pdf)

Rx Inderal (pdf)

Rx Intron A (pdf)
Rx Lidocaine (pdf)

Rx Lisinopril (pdf)

Rx Lotrisone (pdf)

Rx MiCort  (pdf)

Rx Naprosyn (pdf)

Rx Nifedipine/Lido (pdf)

Rx Nitroglycerin Oint (pdf)

Rx Novacort  (pdf)
Rx NuLYTELY (pdf)

Rx Orabase Paste (pdf)
Rx OsmoPrep
Rx OTC Major Surgery

Rx Percocet (pdf)
Rx Phenergan

Rx Pilonidal Package (pdf)

Rx Podofilox (pdf)
Rx Prilosec

Rx ProCort (pdf)
Rx Proctofoam HC(pdf)
Rx Pyridium (pdf)
Rx RectaGel HC

Rx TCA Elavil (pdf)

​Rx SNRI Cymbalta (pdf)

Rx Suprep (pdf)
Rx TriLyte (pdf)
Rx Tylenol #3(pdf)

Rx Ultram  (pdf)
Rx Valium(pdf)

Rx Veregen (pdf)

Rx Viagra (pdf)
Rx Vicodin (pdf)
Rx Vytone

Rx Z Pack (pdf)
Rx Zantac  (pdf)

Rx Zofran (pdf)

CPT Coding Rules

GotNPI.com: CPT Prices & Correct     Coding Initiatives (CCI) Edits

Medicare Published "NCCI Procedure to Procedure (PTP) Edits" for Coding
ICD-10 Lookup

ICD-9 to ICD 10 Cross Coder
CMS Local Carrier Determination (LCD) Policy Lookup Alphabetically

Medicare Payment Lookup

Medicare Payment Settings

Debridement   

HRA BCBS

HRA Aetna

Pudendal Nerve Block

Colorectal & Anal CPT Codes​

CMS Global Surgery Period Booklet

Modifier-reference-guide    Anorectal Wall Biopsy & Modifiers

Modifier -25

Price List Proctology Coviden

Reports

Anesthesia Note
Colonoscopy Note
Decision Making
Eval & Mgt Guide CMS
Eval & Mgt Guide Summary
History & Physical Form
History & Physical Report
Progress Note

Communications
Medical Records Release (pdf)
Work & School Excuse (pdf)

Postoperative Questionnaire (pdf)

Hosp Communications
Place - Warner Park (pdf)
Place - Abrazo Central (pdf)
Surgery Prescription Slip

Post Operative Instructions
Anal Dilators
Banding
Colonoscopy
Diet After Surgery
Infra Red Coagulation
Pilonidal Cyst
Rectal Office Surgery
Rectal Surgery
Upper Endoscopy

What To Expect After      Genital Wart Surgery

What To Expect After      Rectal Surgery

​

Coding for Teaching
CMS E&M Codeing Manual

OLD SUPERBILlS

Proctology - 2015

Genital Warts Center - 2015

Policy
Appointment Policy

Appointment Confirmations

BCBS Clinic Policy -     Assignment of Benefits

Preoperative Preparation

Fasting & Clean-out (pdf)
Avoid These Drugs (pdf)
Colonoscopy – Miralax
Colonoscopy – NuLytely/TriLyte
Colonoscopy – OsmoPrep
Flexible Sigmoidoscopy
Rectal Surgery – Hospital
Rectal Surgery – Office

Suprep Instructions (pdf)

Consents

Anorectal Surgery
Colonoscopy

Interferon Informed (pdf)
Pilonidal Cyst

Proctology (pdf) 1-7-17

Proctology/Endoscopy

Surgical Procedures (pdf)
Upper Endoscopy
​Conscious Sedation & Procedures Consent (pdf)

Copyright © Top Rate Doctors

OFFICE VISITS

New Visit (pdf) 9-26-2019

FollowUp Visit (pdf) 9-26-2019

FollowUp Visit Upgrade: 99215 (pdf)

Conscious Sedation Documentation (pdf) 8-17

Medical Assistant Services (pdf)

Conscious Sedation & Consent Reaffirmed (pdf) 6-19

Procedure Note Checklist (pdf)

Place Of Service
Abrazo Central Campus

Warner Park Surgery Center

Patient Handouts
Pap Screening Guidelines

Pearly Penile Papules PPP

Hypertensive Crisis

​Analgesia for the     Breastfeeding Mother

REFERRALS
Tri-City

McConnell

McClary (pdf)

Verma (pdf)

Harmony Healthcare

Kahn (pdf)

SWCN Medical Center (pdf)

Surgical Center of Scottsdale

Scheduling Slip

​Out of Pocket Letter (pdf)

Place Of Service
 Abrarzo Scheduling

 Warner Park Scheduling

Credentialing
Curriculum Vitae (pdf) - 2-15-16

Proctology Name Change to

  Colon & Rectal Surgery

Virus Warning: Error Corrupted Files Contain Trojan Worms, DO NOT OPEN FILES!

Miscellaneous

Anal Hygiene
Anti-Itch

Cotton Roll Rx
Fodmap Diet
High Fiber Diet
Kegel Exercises
Perfecto Recto Award

Home Health

Nursing Pilonidal Orders
Nursing Proctology Orders
Pharmacy Pilonidal HH
Pharmacy Surgery HH

New Packaged Forms
Office Treatment 6-18

Minor Surgery Post-op

Minor Surgery Pre-op

Rx Intron A Package (signed)

Major Surgery 8-7-18

Miralax Packet 3-17
NuLytely/TriLyte Packet 3-17

Registration 11-18

Suprep Packet

ECCO

Nitrous Oxide Consent (pdf)

Hospital Orders

Pilonidal Cyst Orders
Rectal Surgery Orders

Hospital Forms

Colonoscopy report

EGD Report

Operative Report

Fistula Plug Instructions

Rx Pilonidal Pkg (pdf)

Letters

Anal Wart Letter
Back Pain & Hemorrhoids
Colon Adenoma Letter
Confirmation of Consult
Greater than Usual Svc Letter
Motility Study Referral Letter
Thank You Letter to Doctors
Thank You Letter to Patients
Yearly Recall Letter

Five Points Health Center

Ad
Brochure
Clinic Policy
MMJ ID Cards
History & Physical Form(pdf)
Letter to Primary Care Physician
Medical Records Release
Medical Records Statement
Physician Certification of an Adult
Physician Certification of a Minor
Progress Note
Registration Package

BILLING

Master Superbill (pdf) 9-3-19 ​

EuroMed

PA Supervising Agreement (pdf)

- (Ivette.pdf)

Supervising Physician Rules

​Homeopathic administrative code

Old Packaged Forms
OsmoPrep Packet
Surgery Full Packet
Surgery Light Hospital
Surgery Light Office
Surgery + Miralax
Surgery + Nulytely/TriLyte
Surgery + OsmoPrep

Financial Information

ABN Mecicare

ABN Federal(pfd)
Attorney Lien
Federal Waiver
Financial Hardship
Refund & Liability Release

Intron A Prior Auth(signed)

Practice Guidelines

Hypertensive Crisis Mgt

Bupivicaine Max Dosage

HSIL AIN Comparison

Patient Positioning Sheet

Registration

Clinical Policies (pdf)
Informed Consents (below)
Notice of Privacy Policies (pdf) 1-17
Pt Communication Auth (pdf) 1-17
Patient Questionnaire 1-7-17
Personal Information
Registration Packet (See above)