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HPI status of chronic conditions

  1. #1
    East Stroudsburg
    Default HPI status of chronic conditions
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    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
    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
    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
    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
    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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