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IRF: Physician Query Forms

$ 350.00

The Physician Query Forms are designed to help ensure that each facility's physician documentation provides the detail specifically needed to support the most accurate codes recorded on the IRF-PAI and that this information not only validates the conditions being cared for, but also improves the facility's outcomes and financial performance.

Depending on your IRF's practices, coders, CDIs, and even PPS coordinators can use this robust package of forty-one forms to help your physicians provide the details required to support each patient's conditions to the highest possible degree of specificity.

With our Physician Query Forms, you can be sure that physician query guidelines are being followed, the questions are not leading, and your forms provide adequate space for a quick and accurate physician response that will the details needed to assign the most accurate code.

Why recreate the wheel? These query forms are available as PDF files you can use in your EMR.

Query forms

1. Anemia 22. Pain

2. Anemia, except hemolytic and aplastic

23. Paralysis of the vocal cords and larynx
3. Antibiotic therapy 24. Paralytic condition
4. Atherosclerosis 25. Pathological fraction
5. Body mass index 26. Pelvic fracture, acetabulum
6. Burns 27. Pelvic fracture, except acetabulum
7. Cellulitis 28. Pneumonia
8. Clarification of AKI acronym 29. Polyneuropathy / peripheral neuorpathy 
9. Clarification of dysphagia 30. Postoperative infection
10. Congestive Heart Failure 31. Pressure ulcer
11. Diabetes mellitus 32. Renal disease
12. Disc disorder 33. Respiratory failure
13. Dysphagia 34. Spinal stenosis
14. Encephalopathy 35. Spondylopathy
15. Femur fracture 36. Spondylosis
16. Hemiplegia / hemiparesis 37. Traumatic brain injury
17. Hip fracture 38. Traumatic spinal cord injury
18. Hypertension 39. Upper digestive system disorder
19. Liver disease 40. Urinary tract infection
20. Lower digestive system disorder 41. Weakness
21. Low oxygen saturation levels


The Physician Query Forms are available as a single package for $350.

Please note: After purchasing, the download will begin automatically and can take several minutes. You will receive an email once your download is ready.