Location - "Where is it" - site, diffuse, localized
Quality - "What kind is it" - sharp, dull, constant
Severity - "How bad is it" - pain scale 1-10, mild, severe, worsening
Duration - "How long" - length of time it has been present
Timing - "Is there a pattern" - continuous, repetitive, relation to something else.
Context - "What brings it on" - does it occur with a specific activity
Modifying Factors - "What makes it better or worse" - treatments tried
Assoc. Signs/Symptoms - "What comes with it" - other symptoms that accompany the main complaint.
In your example you have Location (abdomen), Duration (yesterday), Assoc signs/symtpoms (belching /constipation).
I'd be willing to listen to arguments that would give credit for Modifying Factors since a previous episode "spontaneously resolved." I am conflicted about giving credit for that.
F Tessa Bartels, CPC, CEMC
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