# pfsh help



## alices (May 18, 2012)

can someone please help?? I seem to be having a few problems lately when it comes to the HPI and now the PFSH, what level would you all give.

cc- sob, hpi-pt presents c/o sob has chronic asthma, pt buys his meds from mexico flea mkts, pt has been sob for several days, getting worse, assoc-cough no fevers and no modifying factors, ros-is complete, pfsh-asthma social hx is chked=2, exam-complete
dx is status asthmaticus, meds given albuteral, atrovent, prednisone, with 3 breathing tx.,

my problem I think that I am having is that if it is a chronic condition then it is a 2 estab priob worsening, and if there is no other dxs/labs or anything to put into the table B , table C we have the meds/treatment the only level is the 99282 and for me it just doesn't look right/feel right I don't want to over code but I really don't want to under code either, I hope that someone will help me with this, hopefully I explained it right..thanks alice


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## FTessaBartels (May 18, 2012)

*Are you having problem with History or MDM?*

I'm somewhat confused by your post.  Is your problem with determinining the level of history?  Or is it the MDM?

Can you clarify?

F Tessa Bartels, CPC, CEMC


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## DeeCPC (May 20, 2012)

What do you mean ROS-is complete and exam -complete?  Is that what the doctor is stating in the note ("I obtained a complete ROS and performed a complete exam"?  or are you counting the elements and just stating that it is complete?

It would be easier if we could see the actual note -redacted.


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