Medicare does state that documentation must be signed in order to be acceptable. I recently had a request for redetermination denied by them because without noticing it, I sent as documentation an office note that had not been electronically signed yet. Medicare actually stated in their decision letter that had the office notes been signed, they would have reprocessed the charge for payment. Fortunately, there is another level of appeal. I say all that to say that what that person said about Medicare is true. So really, it's not good to code from preliminary reports, which is basically what an unsigned report is. The doctor could very well go back to sign the report and change something that affects the coding unbeknown to the coder. I guess it would depend upon how your documentation system is set up, but until the doctor has finalized and signed the report, it really shouldn't be coded.
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