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Urology Coding Alert

Aspects of PFSH

Published on Fri Apr 15, 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 Metro Urology in St. Paul, Minn., including:prior major illnesses and injuries prior operations prior hospitalizations current medications allergies age-appropriate immunization status age-appropriate feeding/dietary status. Urology examples: "Patient had a sling operation one year ago for incontinence; patient has spina bifida; patient had a kidney stone episode 12 years ago; patient had a negative prostate biopsy six months ago," Gross says.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 children specific 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. Urology [...]
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