When completing your chart deficiencies, don't forget about the Dictation and Missing Text. Look in the Reason section for any questions and requests. Please remember to write legibly for patient care and safety.
ICD-10-CM/PC implementation date is set for October 2014. Coding Education continues on ICD-10 training with coders and physicians.
Continue to document every diagnosis that is being treated, monitored or evaluated. Remember inpatient coding can code possible, questionable, rule out and suspected diagnoses.
Detailed ICD-10 information will be available in future issues of Vital Signs.