AAPC - Back to school
Results 1 to 3 of 3

Thread: pain as a vital?

  1. #1
    Join Date
    Apr 2007

    Default pain as a vital?

    AAPC: Back to School
    Can anyone tell me if pain assessment can be counted as a vital in the constitutional system? Or if it doesn't count there, does it count anywhere?

  2. #2


    I believe that pain would fall under HPI as in description of location, quality, severity, timing, context, modifying factors and associated signs and symptoms.

  3. #3
    Join Date
    Apr 2007
    Lubbock, TX


    Quote Originally Posted by anneabel View Post
    Can anyone tell me if pain assessment can be counted as a vital in the constitutional system? Or if it doesn't count there, does it count anywhere?
    Pain is a constitutional symptom, but it's given credit with the area/organ causing it. It is given credit in the history, because it is described subjectively by the patient - it's either the chief complaint, with HPI giving specifics (eg, 'back pain' for location, 'aching or stabbing pain' for quality, 'an 8 on the pain scale' for severity, etc.), or it's an associated sign/symptom (eg, patient with a swollen knee that is also painful).

    For the ROS/exam, it's credited where it's identified: 'sore throat' in ROS is counted under ENT, and 'leg pain' would be considered musculoskeletal. The same goes for the exam - under 1997 guidelines, several bullets in the multi-system exam actually mention pain specifically, such as under the gastrointestinal portion (examination of abdomen, with notations of any tenderness) - it's generally referred to as "tenderness" versus pain, because the exam is meant to be objective (from the physician's point of view), and he can observe the patient's reaction to tenderness in specific locations that he's moving or prodding, but it's difficult for him to identify/quantify "pain", since he can't feel it in the same way that the patient does. Hope that made sense!
    Last edited by btadlock1; 08-26-2011 at 12:20 AM.

Similar Threads

  1. E/M visit without vital
    By mracioppi in forum Billing/Reimbursement
    Replies: 5
    Last Post: 09-12-2011, 03:01 PM
  2. Vital capacity, total
    By NESmith in forum Modifiers
    Replies: 2
    Last Post: 02-23-2010, 11:47 PM
  3. Vital Signs - Documentation
    By lapcpc in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 06-22-2009, 07:56 AM
  4. JCAHO and Pain as vital sign????
    By RebeccaWoodward* in forum E/M
    Replies: 1
    Last Post: 09-25-2008, 01:00 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.