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HPI and 1995 guidelines

  1. Default HPI and 1995 guidelines
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    Would this be accurate to say that under 95 guidelines if there is no chief complaint that you can use 3 chronic or inactive conditions? Or does this apply only to 97 guidelines? I thumbed through the CPT book couldn't find an answer and emuniversity.com states you can only use 3 chronic or inactive conditions under 97 guidelines...

    Please help!

    Thanks,

    dscoder74

  2. #2
    Location
    Milwaukee WI
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    4,466
    Default HPI vs Chief Complaint
    The chief complaint must be stated on all documentation.

    The HPI can be either the elements (location, quality, severity, timing, duration, context, modifying rfactors, associated signs/symptoms) OR the status of 3 chronic conditions.

    This "3 chronic conditions" was added with the 1997 guidelines, but was never stated that it could apply to the 1995 guidelines. Nevertheless, some carriers will allow you to "mix" the 1997 and 1995 guidelines by accepting the 3 chronic conditions for HPI while still using the 1995 guidelines for the exam.

    Check with your carrier. And be sure to include the protocol in your practice's compliance plan.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Location
    North Carolina
    Posts
    3,126
    Default
    An extended HPI consists of at least four elements of the HPI or the status of at least three chronic or inactive conditions.

    !DG: The medical record should describe at least four elements of the present
    illness (HPI), or the status of at least three chronic or inactive
    conditions


    Page 9 on the '97 guidelines

    http://www.cms.hhs.gov/MLNProducts/D...ds/MASTER1.pdf

  4. #4
    Default
    Quote Originally Posted by dscoder74 View Post
    Would this be accurate to say that under 95 guidelines if there is no chief complaint that you can use 3 chronic or inactive conditions? Or does this apply only to 97 guidelines? I thumbed through the CPT book couldn't find an answer and emuniversity.com states you can only use 3 chronic or inactive conditions under 97 guidelines...

    Please help!

    Thanks,

    dscoder74

    It is highly recommended that they state a CC, but not required. As long as it can be clearly inferred from the note, that is acceptable.

  5. Default Thank you!
    Thanks to all of you, I have been up to my ears with dictation. Sorry for the late response, until next time....

    Have a great day!

    dscoder74

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