he can always amend his record to include it, even if pt is gone.
Check with your local Medicare carrier to be sure, but...
I was at a recent E/M seminar with my MAC which is WPS. She stated the CC is required of every E/M visit, but later stated on subsq inpatient visits, if there was no CC, the "entire record" could be submitted in it's place. I don't agree with this at all, but will certainly take advantage of the idea if needed.
However I still drill it into my docs that EVERY visit should have a CC!
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