• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below.
  • We're introducing new features and a new look to make the forums easier to use and more valuable to you. See what's new and let us know what you think!

Severity HPI

Messages
161
Best answers
0
Patient has kidney stones and in the HPI physician says she does describe some urinary frequency, but drinks quite a bit of water throughout the day. Can I use some as severity?
 

Chelle-Lynn

True Blue
Messages
644
Location
Modesto, CA
Best answers
0
I personally would not classify "some" as a level of severity. With that said, there is no guidance indicating what wording can be used to support severity. Therefore, any word or phrase that conveys the severity of the condition can be credited. Common examples expressing severity that would meet this standard; mild, moderate, severe, unbearable, worsening, etc.

When it comes to HPI it can be a judgment call on the part of the coder. I always advise to level based on what you would feel comfortable defending before an auditor when the definitions are imprecise.
 

twizzle

True Blue
Messages
1,131
Location
Sarasota FL
Best answers
0
Patient has kidney stones and in the HPI physician says she does describe some urinary frequency, but drinks quite a bit of water throughout the day. Can I use some as severity?
I personally would not accept 'some' as severity. If the provider had just documented 'urinary frequency' you wouldn't have any less information than 'some urinary frequency'....... it's basically saying they have it, not how badly they have it.
 
Top