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Thread: What is an Interval History?

  1. #1

    Red face What is an Interval History?

    What is an interval history? And does it apply to these visits? Still learning about hospital coding and help will be appreciated!


    Subsequent hospital care

    Follow-up inpatient consultations

    Subsequent nursing facility care

    Thank you!

    GeminiCoder74

  2. #2
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    An interval history is what happened to the patient between the time the MD visits. It usually reads something like: patient had a good night according to patient, family, nursing staff, etc. Or can also be reports of SOB, tacchycardia during the night but now reporting normal. You need this information for all subsequent visits.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  3. #3

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    Hi Cyndi,

    Thank you for your fast reply. I am sorry I still don't understand. For an Interval history, how many elements of the HPI would you need if any, how many ROS if any and PFSH is any of that required in an Interval History?

    Thanks

    GeminiCoder74

  4. #4
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    An interval history is part of the HPI. You count the elements as you would for any other E/M. Subsequent hospital E/Ms are 99231(pf hx and exam and sf mdm 2/3). 99232 (ef hx and exam and mod mdm 2/3). 99233 (det hx and exam, high mdm 2/3). F/u inpatient consults are billed as above. I haven't billed subsequent nursing facility in a while I can't remember the needed elements for those E/M codes.

    I have given my MDs a quick glance reference from emuniversity.com. One of my docs shrunk and laminated his copy and carries it in his Palm carrying case. He says its really helped him.

    I hope this answers your questions?
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  5. #5
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    Hi Gemini, I don't know if I can shed any light on this for you either but I just listened to a webinar on E&M coding this morning and it did cover this somewhat. She explained that, suppose a patient comes in and has a full work up done. Then he comes in the next day ar later that week. The doc does not have to do the history again, but he must document that he has reviewed the documentation from a previous visit and he must also document, in his current chart, where the previous documentation can be found. The same goes for a doc who has seen a patient for say over 20 years. He can also document history the same way as I just explained, as long as he documents everything. The list she gave us of common codes to use interval history on were all subsequent codes (ie., sub hospital care, sub nursing care, sub domicary care, sub home care). Those codes she specifically mentioned. I don't know if there are more codes that you can use them on, though, so maybe someone else can help with that. I would also be interested if there are other codes that can use interval histories as well. Oh, and she did say that interval coding is covered in the DG's, for 95-pg 8 and for 97-pg9. Good luck

  6. #6
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    Default E/M University & 1997 guidelines

    The question of the week was about a subsequent hospital visit and specifically addressed the Interval History.

    Go to http://emuniversity.com/COW/case012010.html

    If this link doesn't work go to www.emuniversity.com
    Then click on the CASE OF THE WEEK link on the left hand column. Should take you to the current week's case. You want the case for 1/20/10.

    Once you have the case up, click on the link to "view this week's answer in PDF file" ... that will give you all the reasons for the codes selected. If you click on the aqua circle with question mark next to the History grid it will open a box that explains about the "interval history" requirements NOT requiring any PFSH per 1997 guidelines

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  7. #7
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    I have to agree with Cyndi and Tessa about the emuniversity webpage. The questions of the week are great and they also archive all of their older questions of the week so you can take a look at a bunch of them. I am learning so much from those. It's a great resource!

  8. #8
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    So how do you "audit" an interval history? How do you decide whats problem focused vs. detailed? Do you use the previous history?

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    Default Each note stands alone

    Quote Originally Posted by LINDALOUV View Post
    So how do you "audit" an interval history? How do you decide whats problem focused vs. detailed? Do you use the previous history?
    No, you cannot use documentation from a previous note. Each note stands alone.

    The interval history is the same as the HPI except it only covers what has happened since the last time the doctor visited. It is used for subsequent hospital visits, subsequent nursing facility care visit and some other visits (check CPT). The elements remain the same as for HPI (location, duration, timing, quality, severity, context, modifying factors, associated signs).

    For Problem focused and EPF Interval History you need 1-3 elements.
    For Detailed or Comprehensive Interval History you need 4+.

    F Tessa Bartels, CPC, CEMC

  10. #10

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    Oh my gosh! Thank you to all that responded! I have not been on the site for a little while. Your help has been tremendous!

    Have a great weekend everyone!

    GeminiCoder74

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