ED Coding and Reimbursement Alert

You cannot code higher-level E/Ms without extended HPI. Properly counting the history of present illness (HPI) elements your ED physician addresses can make a world of difference in your E/M coding, as certain E/Ms are typically not possible without high-level HPI. Start HPI With First Symptom Coders should consider HPI a "description of the development of the patient's present illness, from the first sign or symptom to the present," explains Tracey Koch, CCS-P, ER client support coding and education manager at Comprehensive Medical Management in Newport, Ky. "HPI is the most important part of patient assessment. When you have a good history, 90 percent of the time the physician can identify what is wrong with the patient; he'll then spend the other 10 percent confirming what he learned in the history," says Joan Gilhooly, CPC, CHCC, president of Medical Business Resources LLC. Example: A patient reports that she has urinary frequency [...]