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asp9325

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I am part of and Outpatient Hospital Facility. That has physcian offices under that umbrella.

Our offices dictate then the physician signs the transcribed document and it gets scanned. Sometimes there is a lag in time between transcription and when the MD signs the document.

My supervisor is wanting me to code from the unsigned dictation. I am not comfortable with this. We have a large amount of Medicare patient and CMS require either hand written or electronic signature. Her response is she knows it will be signed eventually.

Just wander if others code from unsigned documents am I being unreasonable.
 
CMS (Medicare) Clearly states a medical record MUST have provider signature and credentials in order to be valid as a visit. So no I would not want to chance my certification. Go to the CMS website and look for the Signature requirement page and show that to your office manager.

Good Luck!!
 
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