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HPI elements - auditing some claims

  1. Default HPI elements - auditing some claims
    Medical Coding Books
    I have a question, I am auditing some claims and been noticing some coders have been using fever, shortness of breath, seizure as Location, do any of you guys agree with this as being acceptable??

  2. Wink HPI Elements
    I'm relatively certain that they use these in the HPI because "FEVER" ties to the integumentary system while "SHORTNESS OF BREATH" ties to the respiratory system and "SEIZURE" ties to the nervous system.

    If the HPI reads something like...Patient has had a fever for 3 days of 102 degrees. There is also dizzyness associated with the fever. Patient has been taking aspirin with only mild relief.

    ...you have your location, duration, associated signs and symptoms and modifying factors thereby satisfying the required 4 elements of the HPI.

    Hope this is at least a little bit clearer...

    Have a great weekend,

    Joyce

  3. #3
    Location
    Milwaukee WI
    Posts
    4,466
    Default Not location
    I would not count location for any of these statements. None of them answers the question "where is the problem?"

    Oh, and Fever is constitutional, not integumentary.

    F Tessa Bartels, CPC, CEMC

  4. Default
    Hello, I agree with Tessa. The fever is Constitutional & none of the other statements you mentioned are considered as the location of the problem. So I would say none of those statements would be considered acceptable for the location of the problem.

    Hope this helps!!!

  5. Default Location
    I do E and M coding and I have been advised that in HPI, fever would be constitutional, Shortness of Breath would be respiratory and Seizure would be neurological. Althought it does not specifically say the sstem, you know which system these symptoms refer to

  6. Default
    Mea culpa - I wrote integumentary but meant to write constitutional. I do, however, stand by my comment that SOB is the respiratory and seizures are neurological.

    Joyce

  7. #7
    Location
    Kansas City, MO
    Posts
    431
    Default
    I'm pretty certain that "Location" should be the body area with the problem, not a body system.

    I wouldn't say " I have pain in my neurological".
    Linda Vargas, CPC, CPCO, CPMA, CPC-I, CEMC,CCC
    PMCC Licensed Instructor
    Kansas City, MO Chapter
    President, 2018
    Vice President, 2017
    Member Development Officer 2016
    Harrisonville, MO Chapter President - 2013
    ICD-10 Education Coordinator- 2012
    Chapter President - 2011
    President Elect - 2010

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