Confidential Screening/Billing Report (PM 160) Claim Form ...
ICD-10-CM diagnosis code in the Comments/Problems area. Code 4. ... If a parent reports the child’s birth weight in kilograms, convert the amount to pounds and ounces by multiplying the birth weight by 2.2 and converting the fraction of pounds to ounces. ... Enter a check mark (() in this box when a child has been referred to a laboratory for ... ................
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