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1995 DOCUMENTATION GUIDELINES FOR EVALUATION …

1995 DOCUMENTATION GUIDELINES FOR EVALUATION …

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1995 DOCUMENTATION GUIDELINES FOR EVALUATION AND MANAGEMENT SERVICE S . I. INTRODUCTION . WHAT IS DOCUMENTATION AND WHY IS IT IMPORTANT? Medical record documentation is required to record pertinent facts, findings, and observations about an individual's health history including past and present illnesses, examinations, tests, treatments, and ...

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