Is the moonphase guide for the watch incorrect? It seems like on the watch you can see much more of the moon then what is currently out in the sky. For Nov 4th 2011 the moon is 65% visible while on the watch it seems like it is nearly 80% visible. Am I missing something here?
I wonder if many check the accuracy of the moon phase as much as to the accuracy of timing (I know I don't). Either all 5146 shows this discrepancy or your particular watch is malfunctioning. Hope there is an explanation.
When I set my watch, I sometimes wonder if I am getting the moon centered correctly, then counting the proper number of days to the correct day and for the most part, it seems to line up pretty close to how the moon appears in the sky.
There have been occasions though, where I had a similar experience as you but I may have not set it correctly. With my 5015, the moon phase can be set precisely and I can get that set pretty much on the money every time.
I would try re-setting the moon-phase again to see if you experience the same thing.
On the Patek website when you go to the 5146 page there is a 'Settings Moonphase' section that tells you the correct setting of the moonphase for any particular date. And it doesn't match the actual moonphase.