# Positive vs. negative HPI associated signs/symptoms



## pedscoder21

Hi,

If the HPI states:

_*Patient experiencing throat pain since last night. Taking ibuprofen. No vomiting, no diarrhea.
ROS
Eyes: negative
Respiratory: negative
Gastrointestinal: negative
Skin: negative*_

can the phrase "no vomiting, no diarrhea" count towards the element "associated signs/symptoms"? I have an audit sheet that says associated signs/symptoms can be positive or negative. I find it odd, though, since the negative findings are more of a review of systems.

Any guidance is appreciated


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## slivingston

I look forward to hearing the responses to this as I have had this same conversation with my manager.


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## bmontemayor

*Hpi*

You can use these as the associated signs and symptoms, it should have some positive aspects to the notes as well, however, it doesn't take away from the HPI.

Hope this helps.


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## CatchTheWind

So you are saying that negative for symptoms can count as associated signs & symptoms?


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## jdibble

CatchTheWind said:


> So you are saying that negative for symptoms can count as associated signs & symptoms?



Yes, negative responses can be counted towards associated signs & symptoms. You are giving the doctor 1 point credit in the HPI towards the additional work of finding out if the patient has any symptoms, whether they are positive or negative will help him in determining the medical necessity of his decisions.

Thanks,
Jodi


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## pedscoder21

Thank you!


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## Sabrina.

*credit for negative s/s*



jdibble said:


> Yes, negative responses can be counted towards associated signs & symptoms. You are giving the doctor 1 point credit in the HPI towards the additional work of finding out if the patient has any symptoms, whether they are positive or negative will help him in determining the medical necessity of his decisions.
> 
> Thanks,
> Jodi




Is there any documentation to support this?  I feel this is one of those no guideline/subjective areas but if there is a rule that will support the use of negative s/s then I would very much love to have it on hand.
Thank you


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