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Thread: HPI status of chronic conditions

  1. #1
    Join Date
    Apr 2007
    East Stroudsburg

    Default HPI status of chronic conditions

    AAPC: Back to School
    Hi, Can someone tell me, can you use the status of chronic conditions with a 95 DG exam?
    I have heard both yes and no on this. Thank you.

  2. #2
    Join Date
    Apr 2007
    North East Kansas

    Default Karen

    In the Evaluation and Management Services guide on the Medicare Website, page 8, it states "at least 4 HPI elements or the status of at least 3 chronic", and doesn't specify 95 or 97 guidelines, but if you go into the specific guidelines the '3 chronic' is only in the 97 guidelines.
    Karen Strobel CPC, CPMA

  3. #3
    Join Date
    Apr 2007

    Default May depend on the carrier

    WPS Medicare allows the 3C for both 95 and 97, they say this is per direction from CMS.

    Laura, CPC, CPMA, CEMC

  4. #4
    Join Date
    Apr 2007
    East Stroudsburg

    Default Thank you

    Thank you for your help. I will check with my carriers on this. I did already find out from my Medicare Carrier that they allow it.

  5. #5
    Join Date
    Apr 2007
    Daytona Beach, FL


    Highmark also states that you can either use the HPI or status of conditions for either the 95 or 97 guidelines.
    Jodi Dibble, CPC

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