I am coding E/M for a pulmonology office, mainly hospital critical care, consults, and progress notes. Doctor B never, EVER has a separate chief complaint documented. Doctor A,who runs the practice, hired me to look for errors and help fix them to keep from being audited. How do I approach this issue with the chief complaint? I’ve reviewed 100 charts, and there have been absolutely zero with a chief complaint….technically can those even be sent out? Not sure how to handle it.
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