# Extended HPI--Detailed or Comprehensive????



## LewinFamily (Sep 27, 2010)

I am looking for some documentation that shows that if you have 4 or more HPI components whether you would mark off the HPI under _*detailed*_ or _*comprehensive*_ since both state 4 or more.

Can someone please help me find that information? If I have 5 elements: location, duration, modifying factor, quality and context would it be under detailed or comprehensive if using the 95 or 97 guideline. If I always use comprehensive then a majority of my claims are 99215 since they do a comprehensive physical exam whereas if I use those 5 elements and mark detailed then they would be a 99214.

Thanks!


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## cmcgarry (Sep 27, 2010)

LewinFamily said:


> I am looking for some documentation that shows that if you have 4 or more HPI components whether you would mark off the HPI under _*detailed*_ or _*comprehensive*_ since both state 4 or more.
> 
> Can someone please help me find that information? If I have 5 elements: location, duration, modifying factor, quality and context would it be under detailed or comprehensive if using the 95 or 97 guideline. If I always use comprehensive then a majority of my claims are 99215 since they do a comprehensive physical exam whereas if I use those 5 elements and mark detailed then they would be a 99214.
> 
> Thanks!



The history is three out of three elements - so if you have 4+ elements of HPI, 10+ ROS, but only 1 PFSH, you will get a detailed history.  However, if you have 4+ HPI, 10+ ROS, and 2 relevent PFSH est (3 for new), you will have detailed.  

You can't get your level of history just from the HPI, so that shouldn't drive (by itself) what level your visit is.

Hope this helps,


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## LewinFamily (Sep 27, 2010)

Yes it does.. I am doing it right then.. I just viewed it that if I have 3 PFSH and 10 ROS with 4 HPI then it could be detailed *OR* comprehensive history since extended HPI is under detailed and comprehensive.. But from what you are saying it would be comprehensive exam. 

So it does make sense. Thank you!


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## FTessaBartels (Sep 29, 2010)

*You are confusing HPI and exam*

To get a DETAILED *history* you need 4+ elements of HPI, 2-9 systems reviewed in ROS, and at least 1 element of PFSH.

To get a COMPREHENSIVE *history* you need 4+ elements of HPI, 10 or more systems reviewed in the ROS, and a complete PFSH (3 of 3 for new patients and hospital admits / 2 of 3 for established patients).

The above has NOTHING to do with what level of exam you have. 
The level of exam will depend on whether you are using the 1995 or 1997 guidelines and meeting the requirements of those guidelines.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## LewinFamily (Oct 1, 2010)

Im sorry i just re read what I wrote.. I was speaking about the history not exam. I do understand. Thank you!


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