This educational poster created by Rebecca "Ali" Williams, RN, BSN, CCDS, manager of documentation integrity at Spartanburg (SC) Regional Medical Center & Village Hospital, explains that in order for coders to accurately capture intracerebral hemorrhage physicians will need to specify the...
This PowerPoint shows how information flows from the point of admission to billing, audit, and review. This may be useful to include with your basic training programs for new staff members to help them understand how clinical documentation is captured and translated into codes.
This PDF tip card includes general documentation improvement reminders for physicians. Created by Ronna Mahlen, RN, BSN, C-CDS, this tri-fold card can be printed and shared with physicians and placed in common physician documentation areas.
The attached Word document offers quick documentation improvement tips for specifying the acuity and type of heart failure. Created by Cindy Ulrich, RN, MSN, this document can be printed out and hung in physician common areas or documentation rooms.