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ED Coding and Reimbursement Alert

READER QUESTIONS:

Count HPI, or Risk Choosing Wrong E/M Level

Published on Fri Jun 12, 2009

Question: I am having some trouble understanding the elements of history of present illness (HPI). What exactly are the HPI elements, and why do coders have to count them? Illinois Subscriber Answer: Coders need to count the HPI elements because they are an important part of the history component of the ED E/M services. A brief HPI consists of one to three elements, whereas extended HPI requires four-plus elements. The ED physician must perform an extended HPI in order to satisfy the requirements for a detailed or comprehensive history -- meaning that extended HPI is a requirement for both 99284 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components &) and 99285 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patients clinical condition and/or mental [...]
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