NAMAS - Documentation: Carrying Forward or Ineffective Use of Templates?

We know that HPI, Exam, and Medical Decision Making (MDM) must all be specific to the patient encounter and relevant to the patient's presenting problem. Information carried forward may be found in HPI typically occurs when the provider pulls the old HPI from a previous encounter. Provided they then label it as previous HPI and today's HPI for the purposes of good patient care- then it's completely acceptable. Exams are typically not brought forward, but rather a product of "push button finger" within the EMR- so before you consider these as carry forward; consider that the provider may just not be effectively using their templates. Diagnoses will sometimes carry forward as a problem list for the patient, but again that would not be a problem, because we are only going to count what was relevant to today's encounter. Regarding the data and complexity of what was reviewed, I have seen MANY inpatient EMRs such a Cerner that hold ALL inpatient testing in every note. Again, I'm not going to ping the provider for carrying forward, but rather not count it if he/she doesn't create the relevancy. For example- Patient is IP for 10 days and the chest x-ray from admit day 1 is on my 99231 encounter for day 9 (as well as every day), we must be sensible and understand that unless there is a reasonable cause within the documentation that the provider has needed to re-evaluate that x-ray for 10 days- then we just don't count it.