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Name
Title
Organization
Email
Telephone
Coding Service Requested
(Check all that apply)
Production Coding
Backlog Coding
Coding Audit
Independent Review Organization (IRO)
ICD-9-CM to ICD-10-CM Comparison
Speciality
(Check all that apply)
Ambulance Services
Anesthesiology
Cardiology
Emergency Medicine
Endocrinology
Family Practice
Gastroenterology
General Surgery
Internal Medicine
Interventional Radiology
Obstetrics and Gynecology
Oncology
Ophthalmology
Optometry
Orthopedics
Pediatrics
Podiatry
Psychology
Pulmonary Medicine
Occupational Therapy
Physical Therapy Services
Urology
Record Format
Paper
Electronic Health Record


Expected Start Date
Hours Per Week
Number of Coders
Length of Project
Comments
 

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