Wiki ROS question

AmandaW

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I've read what it says on Medicare- Novitas about it not being considered "double dipping" if you pull the symptoms out of the HPI and use as ROS credit. Does this mean you could actually give ROS credit AND HPI credit?

For example, HPI talks about patient being fatigued, muscle pain, blurry vision - can I use this information for HPI credit AND three ROS's ?
 
You cannot ever use the same documentation as two different parts of a history. You can take the information out of the HPI to make it your ROS, but then that same information cannot be used in your HPI. If you have four elements in your HPI without those associated signs and symptoms, then you can still get a detailed history with pulling them out for your ROS.
 
Thank you for your response,
This statement is confusing & a little vague to me from Medicare.
So, If the HPI talks about certain symptoms, etc, I CAN'T also use that as ROS credit? I thought Medicare says it's not double dipping. Or is it that you CAN use the SAME systems but the ROS still has to be separately documented as a different part of the history?


https://www.novitas-solutions.com/w...tentId=00005056&_adf.ctrl-state=1nj4jw4ig_100

13. When scoring the ROS, can you use the systems addressed in the HPI elements or is that "double dipping"?

ROS inquiries are questions concerning the system(s) directly related to the problem(s) identified in the HPI. Therefore, it is not considered "double dipping" to use the system(s) addressed in the HPI for ROS credit.
 
Novitas does allow you to use information from the HPI as both HPI elements and ROS elements. I came across a letter from 1998 where the executive medical director for HCFA (now CMS) stated "it is not necessary to mention an item of history twice in order to meet the Documentation Guidelines requirement for the ROS". I have sent this letter to the current CMS medical director and his staff is investigating. Of course, the individual MACs will still be allowed to apply their own interpretation to the guidelines.
 
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