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Ros -constitutional

  1. #1
    Default Ros -constitutional
    Medical Coding Books
    quick question with regards to ROS,,
    hpi : pt presents with knee pain since x days. 6/10. tried otc.

    ^^ can we get ros from that statement? musculo?




    another question,, skin tags.. " hpi: presents w/ skin tag. would like to be removed.
    ros: skin: no rash
    PE: constitutional : wdwn
    skin: lesion 11 skin tags
    assessment : skintags

    order cryotherapy 1-15 "

    ^^ can i score a level of service for this encounter or its procedure code only? 11200?

  2. #2
    Default
    1st scenario I say yes, you can count that as review of muscuolo system

    2nd scenario I say no, if the cryosurgery is done the same day the HPI and exam are not enough, in my opinion, to constitute a separately identifiable E&M.

  3. #3
    Default
    thanks for the fast reply! im still mixed up w/ the history part of e/m. does this mean in every chief complaint there is always an ROS? so its very rare to have a problem focus history? it is very confusing if i should pull out an ROS especially when the provider writes in paragraph form.

  4. #4
    Default
    I suppose you could find an element of the ROS in the CC - it wouldn't happen very often, but it's possible.

    I would say that you could not pull out a ROS from the first scenario - I see elements of HPI and a CC, but you aren't able to "double-dip" elements. So if you count the knee pain as the CC, you wouldn't be able to use it again as part of the ROS.

    On the second scenario, I would agree that you would only charge for the cryo on the skin tags (11200)
    Jason Steeprow, CPC

  5. #5
    Default
    You can count that as ROS IF it is not used in the HPI. It can be used in one or the other, not both. Be careful not to double-dip and give credit in HPI and ROS.

    Good luck

    Ali H. Vincent CPC, CPC-EMS, BSHA
    United States Air Force AHLTA Clinical Systems Analyst

  6. #6
    Default
    thank you very much

  7. #7
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    Smile definitely can
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    Quote Originally Posted by jbagsic View Post
    quick question with regards to ROS,,
    hpi : pt presents with knee pain since x days. 6/10. tried otc.

    ^^ can we get ros from that statement? musculo?




    another question,, skin tags.. " hpi: presents w/ skin tag. would like to be removed.
    ros: skin: no rash
    PE: constitutional : wdwn
    skin: lesion 11 skin tags
    assessment : skintags

    order cryotherapy 1-15 "

    ^^ can i score a level of service for this encounter or its procedure code only? 11200?

  8. Default
    It is procedure only, the encounter doesn't qualify for modifer 25 since no service beyond the ususal associated with the procedure is there.

    As for the first case, I think 2 ROS could be used- MS and neuro.

    I quite frankly am amazed about the double dipping remarks. The ROS is always interrelated to the HP. Can you cite documentation to support this rule ?

  9. Default Cpc & Cpc-h
    Try this link in regards to the double-dipping issue:
    http://medicalnewswire.com/artman/pu...cle_6570.shtml

  10. #10
    Default
    i'm with coder911....i would use knee pain as HPI, not ROS.
    Dawnelle Beall, CPC, CPMA, CPC-I
    Licensed AAPC PMCC Instructor
    AAPC ICD-10CM Certified Trainer
    Previous AAPC Local Chapter President & VP

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