Thursday Mar 21, 2024

Issues around elective surgery documentation, Part 1

Elective surgeries are on the rise again following a downswing during the COVID era. Yet, with this rise in these procedures, there are challenges and issues involving correctly documenting elective surgeries that practices and organizations need to consider and address. On this episode, a leading expert on clinical documentation covers this difficult area.



Tomas Villanueva, DO, MBA, FACPE, SFHM

Senior Principal, Performance Improvement Consulting




Rachel Mack, MSN, RN, CCDS, CDIP,  CCS, CRC

Consulting Director, Clinical Documentation Improvement



Show Notes:

[01:21] Planned surgeries

[02:26] Five most common elective surgeries and who has them

[04:15] Why elective surgeries are unique

[05:44] What you need to document – examples

[09:13] Obesity and documentation—capturing a CC


Links | Resources:

To contact Modern Practice:

Rachel Mack’s email:


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