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Wiki Hpi

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espforu

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The document has 2 problems in the HPI, both explained quality for each. I had a physician tell me he can count 2 points for quality. I disagree. I am counted the second problem as a associated sign and symptom and only giving one point for quality.

Should 2 points for quality be counted in HPI? I say no.

Thanks,

Kim
 
Hi Espforu,

You are correct. Quality can only be counted once in the HPI.
That is the same for all levels of the HPI. You can only count location, duration, etc once from the HPI.
 
Hi Kim,

You are correct. Each of HPI elements can be counted only once. Remind the physician that in MDM, the nature of presenting problem is where "additional points" may be counted towards the final EM level.

Medicare First Coast has an interactive worksheet that can guide you and the physician on proper EM calculations.

medicare.fcso.com. Click Evaluation and Management; interactive worksheet,

Have a great day.
 
Thanks for the reassurance. I always second guess myself when a physician is arguing over something.

Most of my response is I am just the messenger and don't make the rules, just abide by them :)
 
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