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Missing documentation

  1. #1
    Default Missing documentation
    Medical Coding Books
    If a doctor forgets to document an encounter and this is discovered months later what is the best way to note the chart that the encounter happened?

  2. #2
    Concord, NC or Rochester, NY
    An addendum could be added but how would a doctor remember exactly what happened? Then it is probably OTL with the carrier so may not be able to be billed anyway.

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