Forms

These sample malnutrition queries were donated by Cheryl Ericson, MS, RN, CCDS, CDIP, CDI education director for HCPro, a division of BLR, in Danvers, Massachusetts, and ACDIS Advisory Board member Mark LeBlanc, RN, MBA, CCDS, clinical documentation manager, at Hennepin (Mo.) County Medical Center, who spoke during the June 10 webinar “Physician Queries: Ensure Effective, Compliant, Regulatory-Based Clarifications.” The queries also appear on the ACDIS website.

These sample ICD-10-CM queries address establishing the relationship between conditions in ICD-10 t. These queries are adapted from The CDI Specialist’s Guide to ICD-10, created and donated by Cheryl Ericson, MS, RN, CCDS, CDIP, AHIMA approved ICD-10-CM/PCS trainer, CDI education director at HCPro, Inc., in Danvers, Mass.

Cheryl Ericson, MS, RN, CCDS, CDIP, AHIMA-approved ICD-10-CM/PCS trainer, CDI education director for HCPro, a division of BLR, in Danvers, Massachusetts, and ACDIS Advisory Board member Mark LeBlanc, RN, MBA, CCDS, clinical documentation manager at Hennepin (Missouri) County Medical Center, donated this sample ICD-10-CM sepsis query.

This query form is a request for documentation clarification of pathology findings. It was submitted by Paul Evans, RHIA, CCS, CCS-P, supervisor of clinical documentation integrity at Sutter Health in San Francisco. It originally appeared on the Association for Clinical Documentation Specialists website.

The Winthrop University Hospital clinical documentation improvement (CDI) specialists and HIM team implemented a new query for cerebral infarctions in preparation for the transition to ICD-10. The newly created form incorporates the language necessary to capture documentation within this new area of enhanced specificity.