CDIP PRACTICE REAL EXAM 1 WITH 100%GUARANTEED SUCCESS NEW UPDATE!!!!

In conducting a qualitative review, the clinical documentation specialist sees that the nursing staff has documented the patient's skin integrity on admission to support the presence of a stage I pressure ulcer. However, the physician's documentation is unclear as to whether this condition was present on admission. How should the clinical documentation specialist proceed? a.Note the condition as present on admission b.Query the physician to determine if the condition was present on admission c.Note the condition as unknown on admission d.Note the condition as not present on admission - ANSWERS-b As a result of the disparity in documentation practices by providers, querying has become a common communication and educational method to advocate proper documentation practices. Queries can be made in situations when there is clinical evidence for a higher degree of specificity or severity (Shaw and Carter 2014; Schraffenberger and Kuehn 2011, 42).