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Family history when patient was adopted

  1. Default Family history when patient was adopted
    Medical Coding Books

    I'm looking for examples of statements for physicians to use for a family history when a patient (child) is adopted. Is it acceptable to just say that the history is unknown because the child is adopted or does that maybe fall under a social history?


  2. #2
    Milwaukee WI
    Default Family Medical History
    The Family medical history helps a physician determine whether there may be any genetic predispositions to certain conditions. It can also help explain possible infectious contacts.

    So for a patient who was adopted there may not be any family medical history available due to adoption.

    Our physicians frequently state this as: Family medical history not known; patient is adopted and biological family records are not available.
    (NOTE: This statement works whether the patient is a child or an adult.)

    If the reason for the visit is a suspected infection the family medical history may include - for [U]example[/U] - Both Mom and sibling have recently had strep throat.

    F Tessa Bartels CPC
    Children's Specialty Group
    Medical College of Wisconsin

  3. Default
    Thank you

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