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Ros -constitutional

  1. #11
    Location
    Greater Portland (Maine)
    Posts
    129
    Default
    Medical Coding Books
    Double-dipping refers to using the same element within one of the history components. In other words, you can use same element for satisfying requirements in HPI and ROS, but you cannot use the same element twice within, for instance, the ROS (example: chest pain can be used in both HPI and ROS, but not as "cardiovascular" and "musculoskeletal" in the ROS.

    Rita Bartholomew, CPC-H
    Maine Medical Center
    Portland, ME

  2. #12
    Default
    I would say no to the first one for sure. That sounds like the CC and you can pull HPI out of there. And you need a CC. Therefore not being able to use as ROS.

  3. Default
    For the question about the skin tags, does anyone else think it's concerning that the surgical procedure isn't documented, eg, prep, actual area on the body where the skin tags were, method of removal, how well the patient tolerated the procedure, post-op care instructions, etc?

    In my personal opinion, the documentation as it is doesn't support 11200. It does support an E/M service with the MDM supporting the order for cryosurgery.

    Kris

  4. #14
    Default
    I'll have to disagree also with the "double dipping" part of the above discussion. With our carrier, Highmark Medicare Services, it is stated as "

    When scoring the review of systems (ROS), can you use the systems addressed in the history of present illness (HPI) elements or is that "double dipping"?

    According to The Medicare Part B Reference Manual, Chapter 23, "Evaluation and Management", section e.3, ROS inquiries are questions concerning the system(s) directly related to the problem(s) identified in the HPI. Therefore, it is not considered "double dipping" to use the system(s) addressed in the HPI for ROS credit.
    Date Posted: 07/18/2005, Date Reviewed/Revised: 12/13/2007

    Link to actual information http://www.highmarkmedicareservices....rvices.html#15

    Shelby

  5. #15
    Default
    I'll have to disagree with the above discussion of "double dipping" in reference to the HPI and the ROS.... Our carrier Highmark Medicare Services posted this on their website and this is what we follow.

    When scoring the review of systems (ROS), can you use the systems addressed in the history of present illness (HPI) elements or is that "double dipping"?

    According to The Medicare Part B Reference Manual, Chapter 23, "Evaluation and Management", section e.3, ROS inquiries are questions concerning the system(s) directly related to the problem(s) identified in the HPI. Therefore, it is not considered "double dipping" to use the system(s) addressed in the HPI for ROS credit.
    Date Posted: 07/18/2005, Date Reviewed/Revised: 12/13/2007

    Link:http://www.highmarkmedicareservices....rvices.html#15

  6. #16
    Location
    Modesto, CA; Central Valley Chapter
    Posts
    225
    Default double dipping
    Great link! I hope everyone will take the time to read that. There is so much miscommunication about the double dipping issue.

    thanks
    tina

    Quote Originally Posted by namt View Post
    Try this link in regards to the double-dipping issue:
    http://medicalnewswire.com/artman/pu...cle_6570.shtml

  7. #17
    Location
    North Carolina
    Posts
    3,126
    Default
    Your first question...this is my training~

    HPI-Location, duration, severity and modifying factors

    2nd question...No...only the procedure

    I work with Ortho/Neuro Surgeons and this has been an extreme topic in our facility with outside consultants. Your 1st scnenario does not have impressionable ROS for me.

    Rebecca

  8. #18
    Default
    thanks for the replies.

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