AHIMA Professional Practice Experience Workbook

Surgeon: Was Anesthesiologist Present?

Y/N (If no, state reason)

Informed Consent Signed Prior to Procedure? By Whom (patient or representative)? Discharge Instructions: Discharge Status: Include statements from the documentation that describe the patient’s “abrasions” and the corresponding treatment: Include statements from the documentation that describe the patient’s “lacerations” and the corresponding treatment:

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