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Coding Query Help Form

Please complete this form when you have difficulty coding a case. Complete a separate form for each problem. Give as much information as possible. If you wish to send any further information or chart documentation, please remove any names or addresses first, then post as usual to the ESRI at the address below, referencing this online. Thank you.

Enter Your Details
Hospital:*
Coder's Name:*
Information Available
Chart Number:*
Admission Date:* (e.g.16/01/2006)
Discharge Date:* (e.g.16/01/2006)
Date of Birth:* (e.g.24/06/1980)
Sex:*
Diagnosis:*
Procedure:
Relevant History or Previous Admissions:
Other Relevant Information:
What is the Coding Problem:*
What is the Doctor's View:
All * fields are required.

The form can be downloaded, by clicking the link below and completed and returned by post.