HPI/ROS Question

ARCPC9491

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What are everyones thoughts on using an item for both the HPI and ROS? (i.e. Abdominal Pain) Many people feel this is ok to use both but some people feel it is not. I've searched for Medicare info on it, and the only thing I have found is that Highmark says it is okay (I think it was Highmark, is that correct? they are not my contractor, Trailblazer is)

I've waffled back and forth with this issue and I want to have a solid take.
 

Lisa Bledsoe

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Unless it is stated twice, it should only be used as one or the other. If it is stated once and you count it twice that is double-dipping...one of the first things I was taught NOT to do...
 

RebeccaWoodward*

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I agree with Lisa; however, I have also asked Medicare about these type of scenerio's...

"chest pain with dyspnea" - you can count the phrase dyspnea as an associated sign/symptom and chest pain could be credited in the Respiratory ROS (Blue indicates Medicare's response)

"Diarrhea with nausea and vomiting"- "you can count the phrase nausea and vomiting as an associated sign and symtom" and Diarrhea could be credited in the GI ROS"
 

rthames052006

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I agree with Lisa; however, I have also asked Medicare about these type of scenerio's...

"chest pain with dyspnea" - you can count the phrase dyspnea as an associated sign/symptom and chest pain could be credited in the Respiratory ROS (Blue indicates Medicare's response)

"Diarrhea with nausea and vomiting"- "you can count the phrase nausea and vomiting as an associated sign and symtom" and Diarrhea could be credited in the GI ROS"

Rebecca,

Those are the types of phrases I look for to be able to count in HPI/ROS also, great points, some people might miss those types of wording.

Thanks for the great examples.
 
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