Language is key in clinical documentation.

Language is key in clinical documentation.

MedLine Citation:	PMID: 21630557 Owner: NLM Status: In-Process
Abstract/OtherAbstract:	Medical language and coding language are not the same, which means that physicians often write what they learned in medical school to describe a patient's condition: if it doesn't contain the proper language, the coders can't accurately code the chart. Educate physicians to use appropriate language to reflect the condition of the patient. Look for hints in documentation by other clinicians that the physician documentation might not be accurate. Ensure that documentation is complete to indicate major complication/comorbidity rates (CCs or MCCs).

Authors:	-
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Publication Detail:	Type: Journal Article
Journal Detail:	Title: Hospital case management : the monthly update on hospital-based care planning and critical paths Volume: 19 ISSN: 1087-0652 ISO Abbreviation: Hosp Case Manag Publication Date: 2011 Jun
Date Detail:	Created Date: 2011-06-01 Completed Date: - Revised Date: -
Medline Journal Info:	Nlm Unique ID: 9603097 Medline TA: Hosp Case Manag Country: United States
Other Details:	Languages: eng Pagination: 84-6 Citation Subset: H
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