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Electronic Signatures

  1. #1
    Default Electronic Signatures
    Medical Coding Books
    I have a director who wants us to code dictated charts without an electronic signature.

    The only charts we can hold are without disposition or diagnosis.

    Isn't this a compliance issue?

  2. #2
    Location
    Milwaukee WI
    Posts
    4,466
    Default Dictation w/o signature
    Because our hospital will suspend a doctor's privileges if s/he is "delinquent" in completing charts (i.e. dictating op reports, admits or discharge notes, AND signing them), we WILL code without the signature, since we feel confident that the signature will be obtained in a relatively short period of time.

    The only ones we hold are notes that require a statement of time spent (sometimes doctors add this info at the time they sign), or are missing diagnosis information (waiting for path, usually).

    F Tessa Bartels, CPC, CEMC

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