Today I was circulating in the OR for a total shoulder. The rep handed me a package that cobtained 4 separate pins. These were used for in and outs. The person who does out charge sheets was furious because I documented each individual pin as an in and out. She said the patient would be charged 4 times. I explained that no I documented each pin on the implant log. She stated that because it came in a 4 pack box that I am to document that only one time on the implant log. Can yall tell me what is your practice for documentin implants and outplants. I was always taught never take shortcuts by saying (x4) always document each individual item.