Aspects of PFSH
Published on Thu May 12, 2011
Per CPT®, past medical, family and/or social history is divided into three subsections.1. Past medical history includes the patient's experience with illnesses, operations, injuries, and treatments, says Leah Gross, CPC, coding lead at a practice in St. Paul, Minn., including: prior major illnesses and injuriesprior operations prior hospitalizations current medications allergies age-appropriate immunization status age-appropriate feeding/dietary status.Examples: "Patient has spina bifida; patient had a kidney stone episode 12 years ago; patient is allergic to penicillin; patient had a thyroidectomy in 2009."2. Family history includes a review of health-related events in the patient's family, including:health status or cause of death of parents, siblings, and childrenspecific diseases related to problems identified in the chief complaint or history of the present illness, and/or system reviewdiseases of family members that may be hereditary or place the patient at risk.Examples: "Both siblings have schizophrenia; mother died at 55 of breast cancer; father has COPD."3. Social [...]
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