Stupid query answers

I just had a doctor reply to a query with "Duh! It's a no brainer!" Now that I have vented to my boss and co-workers, I've calmed down enough to laugh a little bit at it. I thought it might give all of you a little chuckle too. Anyone have any stupid query answers they'd like to share?

Laura Bohls, RN CDS
Prairie Lakes Healthcare System
Watertown, SD

Comments

  • I QUERIED RECENTLY TO A VERY NON COMPLIANT OUTLIER SURGEON. THE QUERY WAS RELATED TO EXCISIONAL OR NON EXCISIONAL DEBRIDMENT-WITH STANDARD WORDING AS THE LEVEL OF THE DEBRIDEMENT; SKIN, SUB Q TISSUE, BONE, FASCIA ETC. HIS RESPONSE? "I CUT HER IN THE OR". NEEDLESS TO SAY, HE DIDN’T SIGN THE QUERY OR ANSWER IT-I GUESS HE THOUGHT HE WAS TRYING TO BE CUTE.
  • I forgot to put in my first posting that the doctor signed the query and our queries are a part of the permanent record. Now who looks like the one without a brain in this situation? :)

    Laura
  • Requested physician to identify "type" of PNA. Response "The type that
  • edited May 2016
    READ MY DICTATION! I am sure we have all seen this one--- If we could just read their minds....:) However, this has worked in some cases as we could all a test I am sure.




    Mary A Hosler MSN, RN
    Clinical Documentation Specialist
    Alumnus CCRN
    McLaren Bay Region
    1900 Columbus Ave.
    Bay City, Michigan 48708
    (989) 891-8072
    mary.hosler@mclaren.org
  • Yup! I had to remind one of our surgeons of this once! :)

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404
  • I had one respond with my 1st name in the query response! (Ours are permanent part of record.) I won't ever forget that one.

    Claudine Hutchinson RN
    Clinical Documentation Improvement Specialist
    Children's Hospital at Saint Francis
    Email: chutchinson@saintfrancis.com
  • edited May 2016
    I queried for type of pna being treated with Vanco-MD response "pt came from a nursing home and was hospitalized within the past 2 weeks so it is obvious that is HCAP. Surprise! I bet you didn’t think I would answer, did you?"

    Our records are part of the permanent record also :)


    Dawn
  • edited May 2016
    I am reminded of a delightful pretend note to Medicare which I'm sure originated on CDI Talk which said something like... Please forgive Dr. ___________. We know he is too busy to document and we can read his mind... does anyone else remember or have a copy of the verbiage? It always brought me a smile on a bad day!!

    Linnea Thennes, RN, BS, CCDS, CCS
    Supervisor, Clinical Documentation Improvement
    Centegra Health System
    815. 759-8193
    lthennes@centegra.com
  • I do have that~ saved a copy because it made me laugh. J. See
    attachment.

    Claudine Hutchinson RN
    Clinical Documentation Improvement Specialist
    Children's Hospital at Saint Francis
    Email: chutchinson@saintfrancis.com
  • edited May 2016
    Lol!!
    That is so funny!. I'll keep it on my desktop for those 'bad' days.
    Renee, RN CDS
  • OMG I laughed my head off at this! Yes get it all the time-especially with the surgeons. My co-worker will just not query them sometimes-he just ask them outright. I have one doctor that when I leave a query for something he needs to specify-he goes all the way back in the progress notes and writes it in-and then leaves a note on my Query form-says see PN and adds the dates to all the progress notes he went BACK to and added what I needed!! Now figure that!! So I know he is trying to make me look stupid, like I missed it!! I know I didn’t!! So we just laugh about it now actually I make a copy of the previous progress notes-just for myself and one day I'm gonna Bust him!! My boss laughs when I tell him this-the physician advisor says he wants to be present when I bust him!! Sorry so long just had to share!!
    Deb
  • edited May 2016
    I queried for morbid obesity. The written response on my query-OMG, have you seen her?
    Kathy Shumpert
  • edited May 2016
    I am so glad you mentioned that!! Does anyone else have that problem? The feeling that physicians are going back and adding the documentation "post query"? Like we missed it? I thought I was missing documentation - I KNOW that I was not! I finally guessed they were going back and adding - but I really didn't have any proof.

    This is almost a whole other discussion but what does everyone do when you are fairly positive you checked for documentation before you left your query but then it shows up "before you queried"? Do you count the documention/query?

    Thanks,

    Norma T. Brunson, BS,RHIA,CDIP,CCS,CCDS
  • edited May 2016
    We do, if it’s one that we know does this habitually. And with some, we make a copy of the note – what’s nice is that as more and more are using electronic notes, the computer keeps track of the addendums☺ and often you can tell because they use a different pen.

    Sharon Cole, RN, CCDS
    CDI Specialist
    254.751.4256
    Sharon.cole@phn-waco.org
  • edited May 2016
    We rarely has this, but if we do we make a note on the query that the information was answered by Dr. XYZ with an addition to Progress note dated 10/4/13. We count is as asked and answered. I am pretty sure this won’t be an option for them when we finally get switched to Electronic Health Record. (?)



    Vanessa Falkoff RN
    Clinical Documentation Coordinator
    University Medical Center
    Las Vegas, NV
    vanessa.falkoff@umcsn.com
    office 702-383-7322
    cell 702-204-0054
  • This string is too wonderful, would you all mind if I compile your thoughts into a brief for the ACDIS Blog?
    Melissa Varnavas | Associate Director
    ACDIS | 75 Sylvan Street, Suite A-101, Danvers, MA 01923
    P 781-639-1872, ext. 3711 | www.acdis.org
  • Yes this does happen where they go back and add the documentation to a previous prog note without noting the new “addition”/addendum. I have made some copies of progress notes before I queried to have proof that I am not “making up queries”. Also I have a couple of physicians that carry their prog notes with them until the very end of the day or in critical care hard copies may not show up for a day or two~ if I don’t see what I am looking for when I round then I send a query and make a note of time on my sheets that there was no physical hard copy on the chart (including if it’s missing documents from resident and/or attending) at time of query. It’s a pain and takes up already precious time but I feel I need to “cover myself”. Also there is a doctor who dictates his notes and it can take days before it’s transcribed. I send a query otherwise there is too much chance of missing diagnoses! I do count the queries from all of these and dr does get credit for answering the query in the chart (instructed by my manager when I discussed the issues with her). Always an adventure in CDI-Peds world J

    Claudine Hutchinson RN
    Clinical Documentation Improvement Specialist
    Children's Hospital at Saint Francis
    Email: chutchinson@saintfrancis.com
  • edited May 2016
    We queried for the BMI on a patient with Morbid Obesity with a form that includes the formula to calculate the BMI. Dr. Funnyman documented the BMI and then added that “he much preferred the Ringling Brothers Circus way of doing this!”



    Vanessa Falkoff RN
    Clinical Documentation Coordinator
    University Medical Center
    Las Vegas, NV
    vanessa.falkoff@umcsn.com
    office 702-383-7322
    cell 702-204-0054
  • That is a fabulous blog idea Melissa.

    Laura Bohls, RN CDS
    Prairie Lakes Healthcare System
    Watertown, SD
  • edited May 2016
    I did have a physician who was queried for type of CHF who documented, "I don't know - ask God."

    We had a surgeon who was asked to document the relevance of a Sodium of 119 and treatment w/IVF in the progress notes.

    He replied, "The relevance is that it gives you a job to do every day."

    It doesn't bother me when they do this - unless we still didn't get the documentation. Its just a human reaction against something you do not quite understand. From their point of view - "saving lives" - how is this going to cure Mrs. So-and-so's Cancer?

    Gotta love what you do...

    Norma T. Brunson, BS,RHIA,CDIP,CCS,CCDS
  • Good Idea I would love to have a copy of all this!! Not that I want you all to share my pain! But good to know I'm not alone in this crazy world of documentation and doctor smarties!! We still have written progress notes so I can tell when it happens and they go back and add documentation on previous PN after my query.
  • I will be away from my office starting on 10/7 and returning on 10/21.
  • I have a folder full of "Query Memories" but my favorite is the above response to read the record with a southern flare.... "Please see my H&P dead gummit". Then on a thank you note I sent, the MD responded "Send Money". Morbidly obese? "Yes, she is a big girl". At least they have a sense of humor...

    April Floyd, RN, CCDS
    Anderson RMC
    Meridian, MS 39301
  • edited May 2016
    Thinking this would make a good blog post. See attached. You guys are wonderful. :)
  • Great! Thank you :-)

    Claudine Hutchinson RN (CDI)
    The Children's Hospital at Saint Francis
    chutchinson@saintfrancis.com
  • Asked an orthopedic surgeon to address a precipitous postoperative drop of greater than 20% H/H monitored with serial CBC and treated with 2 units PRBC....Response: "Ask one of the doctors on staff, I only break bones"

    Paul Evans, RHIA, CCS, CCS-P, CCDS
     
    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell:  415.637.9002
    Fax:  415.600.1325
    Ofc:  415.600.3739
    evanspx@sutterhealth.org
  • I don't recall the specific question, but the answer was simple & short enough to remember:

    "DUH!"

    Don

    Donald A. Butler, RN, BSN
    Manager, Clinical Documentation Advisor Program
    Vidant Health, Greenville NC
    DButler@vidanthealth.com ( mailto:mDButler@vidanthealth.com )
  • edited May 2016
    "Who do I look like to you-the Amazing Karnak??"

    Cathy L. Seluke, RN, BSN,CCDS, ACM
    Supervisor Clinical Documentation Compliance
    MaineGeneral Medical Center
    Alfond Center for Health
    35 Medical Center Parkway
    Augusta, ME 04330
    P. 207.248.5093
    Cathy.Seluke@mainegeneral.org
  • Just saw this one today - a written response to a chronic respiratory
    failure query. "It's probably time for me to retire.......too much stupid
    stuff." Poor guy - he really did give it "the old college try" before he
    reached this point.

    Cindy Pritchett, RN, BSN, CCDS
    MedPartners Consultant
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