Skin Biopsy Procedure Note

Rate this item
(5 votes)
PRE-OP DIAGNOSIS: _
POST-OP DIAGNOSIS: Same 
PROCEDURE: skin biopsy
Performing Physician: _ 
Supervising Physician (if applicable): _
 
PROCEDURE: 
_  Shave Biopsy        _  Excisional Biopsy        _  Punch (Size _)
 
The area surrounding the skin lesion was prepared and draped in the usual sterile manner. The lesion was removed in the usual manner by the biopsy method noted above. Hemostasis was assured. The patient tolerated the procedure well.
 
Closure:     _  Monsel’s for hemostasis              _  suture _                   _  None
 
Followup: The patient tolerated the procedure well without complications.  Standard post-procedure care is explained and return precautions are given.
  • All templates, "autotexts", procedure notes, and other documents on these pages are intended as examples only.  Your documentation in the medical record should always reflect precisely your specific interaction with an individual patient.  Merely copying and pasting a prewritten note into a patient's chart is unethical, unsafe, and possibly fradulent.