1. A

    Wiki Cancelled procedure documentation

    There seems to be some debate. In an outpatient/day surgery setting, does a provider need to document the reason why a procedure was cancelled and sign off on it? Or is it sufficient for the nurse to write the reason why in a progress note/nurse note. Specifically if its cancelled due to pt...
  2. S

    Wiki Breast Bx- Dx code

    When billing for a breast bx, is it best to wait for the pathology report to come back to be able to bill with final dx, or can we bill with the reason the bx was done? Thanks