ALL our clinic notes are letters
Our surgeons dictate ALL clinic notes as letters to the PCP or requesting physician (depending on the nature of the visit).
They usually start with a summary paragraph that includes their findings and recommendation, and then continue with the complete history, exam, assessment/plan. This lets the PCP stop reading after the first paragraph if s/he is so inclined, and still get the needed info.
You are not going to find anything in writing, Kim, that tells you that this is specifically okay. Your code should be assigned based on the elements documented, no matter how they're documented or in what order.
Hope that helps.
F Tessa Bartels, CPC, CEMC