IRF: Physician Query Forms
The Physician Query Forms are designed to help ensure that each facility's physician documentation provides the detail specifically needed to support the most accurate codes recorded on the IRF-PAI and that this information not only validates the conditions being cared for, but also improves the facility's outcomes and financial performance.
Depending on your IRF's practices, coders, CDIs, and even PPS coordinators can use this robust package of forty-one forms to help your physicians provide the details required to support each patient's conditions to the highest possible degree of specificity.
With our Physician Query Forms, you can be sure that physician query guidelines are being followed, the questions are not leading, and your forms provide adequate space for a quick and accurate physician response that will the details needed to assign the most accurate code.
Why recreate the wheel? These query forms are available as PDF files you can use in your EMR.
Query forms
1. Anemia | 22. Pain |
2. Anemia, except hemolytic and aplastic |
23. Paralysis of the vocal cords and larynx |
3. Antibiotic therapy | 24. Paralytic condition |
4. Atherosclerosis | 25. Pathological fraction |
5. Body mass index | 26. Pelvic fracture, acetabulum |
6. Burns | 27. Pelvic fracture, except acetabulum |
7. Cellulitis | 28. Pneumonia |
8. Clarification of AKI acronym | 29. Polyneuropathy / peripheral neuorpathy |
9. Clarification of dysphagia | 30. Postoperative infection |
10. Congestive Heart Failure | 31. Pressure ulcer |
11. Diabetes mellitus | 32. Renal disease |
12. Disc disorder | 33. Respiratory failure |
13. Dysphagia | 34. Spinal stenosis |
14. Encephalopathy | 35. Spondylopathy |
15. Femur fracture | 36. Spondylosis |
16. Hemiplegia / hemiparesis | 37. Traumatic brain injury |
17. Hip fracture | 38. Traumatic spinal cord injury |
18. Hypertension | 39. Upper digestive system disorder |
19. Liver disease | 40. Urinary tract infection |
20. Lower digestive system disorder | 41. Weakness |
21. Low oxygen saturation levels |
The Physician Query Forms are available as a single package for $350.
Please note: After purchasing, the download will begin automatically and can take several minutes. You will receive an email once your download is ready.