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Would you count "intent" (suicidal) as severity in ER HPI?

Abbi Schoenhofer

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:confused:In coding for ER, we audit directly from a t-sheet, and when we have patient present with depression, thoughts of suicide, suicidal ideation...etc, the physician will sometimes circle "suicidal" under the Intent section of the HPI. Some of our coders will count this as severity and others do not. I am looking for good information to make the case one way or the other to develop a standard policy for our coding dept. on this. Thanks for any help you have to offer on the subject!

Abbi
 

1073358

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I would think that you could count it if you need it. If a patient is so depresses that they are suicidal, in my opinion that indicates severe depression. Its obviously not just mild if suicide intent is there
 

kevbshields

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I do not profess to being an E/M expert, just someone who'd done quite a bit of the coding over time.

Anyhow, could you count it as Context? It's not just suicidal ideation (quality, right?), but with an intent. I also think it would illustrate the context in which the depression and other symptoms arise. But hey, that's my take. I could also see it argued as an Associated Sign/Symptom.

DSM lists suicidal ideation under the manifestations of depression, if I'm not mistaken.
 
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