One of the biggest issues I've run into over the last 9 years as an anesthesia and pain management coder is that we frequently don't have access to all the pt's information. Due to the nature of the specialty we're lucky to get a charge sheet, demographic info and an anesthesia graphic record. I think that if your doctor indicates 650 it is perfectly acceptable to bill it. You can't go chasing down the entire medical record of every patient, it just isn't financially feasible. Having said that, I would caution you, that you are charged with coding to the highest specificity possible. So, in light of that, if you are able to easily get the pre-anesthesia intake info on all your patients I would recommend it, as they often have very useful info included in them.
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