Query Forms

This sample query for hypertension specifity was provided by Jillian Bisbe, RN, MSN, CCDS, supervisor of CDI at Lee Health in Fort Myers, Florida. Bisbe is a member of the Forms & Tools Library Committee.

Please note that this query is sent electronically in EPIC. The...

This sample query for pneumonia specificity was provided by Jillian Bisbe, RN, MSN, CCDS, supervisor of CDI at Lee Health in Fort Myers, Florida. Bisbe is a member of the Forms & Tools Library Committee.

Please note that this query is sent electronically in EPIC. The...

This sample query for renal failure was provided by Jillian Bisbe, RN, MSN, CCDS, supervisor of CDI at Lee Health in Fort Myers, Florida. Bisbe is a member of the Forms & Tools Library Committee.

Please note that this query is sent electronically in EPIC. The title of...

This sample respiratory failure query was provided by Debra A. LeDeox, RN, CCDS, CDI coordinator at Mather Hospital in Port Jefferson, New York.

This sample has been reviewed and approved by the Forms & Tools Library...

The following sample query was donated by ACDIS Advisory Board member Paul Evans, RHIA, CCS, CCS-P, CCDS, Manager, Regional Clinical Documentation at Sutter West Bay in San Francisco. Contact him at evanspx@sutterhealth.org.

Cheryl Ericson, MS, RN, CCDS, CDI-P, CDI Education Director, for ezDI, donated this sample query related to bile leaks.

Robert Hodges, BSN, MSN RN, CCDS, Clinical Documentation Improvement Specialist at the Aleda E. Lutz VA Medical Center in Saginaw, Mich., donated this sample malnutrition query. The Forms & Tools Library committee notes that the option of Kwashikor should be carefully considered before...

Paul Evans, RHIA, CCS, CCS-P, CCDS, Manager, Regional Clinical Documentation & Coding Integrity, at SutterHealth in San Francisco, Calif., offers this sample heart failure query form which includes educational definitions of heart failure, cardiomyopathy and other related concerns.