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Not in my offices

I say no.

The problem with medical records is the fact they are always created after the service took place. It could be immediately after, ie while the patient is still in the room. Or it could days, weeks, months later.

When we have a document with no clear dos we have the provider amend the note to add it. I would be leary of that in your case since it was so long ago. We usually catch ours within a few days of the date of service. There is nothing saying you can't but the further out you are the more questionable the information becomes.

Laura, CPC, CPMA, CEMC
 
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