# Hpi



## elferica (Nov 14, 2007)

I have 2 conflicting documents on whether you can count negative responses in the HPI.  One from Part B News and one from our local Medicare carrier.   I have been searching everywhere that I can think to find more information on this.  Does anyone know where I can find any information on this or maybe have an opinion?  I would really like some more documentation on it.


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## donsqueen (Jan 27, 2008)

HPI is fairly easy to meet. The most common ways to meet HPI are location, pain level, associated signs/symptoms, and modifying factors. (Chief complaint must always be present). Example:  Pt comes in with Rt hand pain (location), 5/10 (pain level), swelling (associated signs/symptoms), and has tried Ibuprofen with minimal relief.  Hope this helps.


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## reichtina320 (Feb 12, 2008)

Yes you can count negatives in the HPI.  I just sent a thread on another list serve and the examples they gave is when asking the patient about the severity, when using the pain scale o no pain to 10 the worst pain.  The also gave a couple other examples.  In CA I have not heard that you cannot count negatives in the HPI.

Thanks
Tina





elferica said:


> I have 2 conflicting documents on whether you can count negative responses in the HPI.  One from Part B News and one from our local Medicare carrier.   I have been searching everywhere that I can think to find more information on this.  Does anyone know where I can find any information on this or maybe have an opinion?  I would really like some more documentation on it.


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## gailmc (Feb 15, 2008)

Would you count negatives for "associated signs and symptoms?"  i.e. pt presents with cough and denies chest pain.  Would the "denies chest pain" be an associated sign or symptom.  I've always said "No", but am getting some pushback from providers.


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## mmelcam (Feb 15, 2008)

I can not see how it could be counted as "associated signs and symptoms". If he does not have the chest pain then how could it be an associated sign or symptom to a cough?


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## rthames052006 (Feb 15, 2008)

gailmc said:


> Would you count negatives for "associated signs and symptoms?"  i.e. pt presents with cough and denies chest pain.  Would the "denies chest pain" be an associated sign or symptom.  I've always said "No", but am getting some pushback from providers.



I would count the CP in the ROS portion of the HPI.

Roxanne Thames, CPC


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## dabroussard (Feb 17, 2008)

*negative replies on HPI*

I have never heard of using negatives on the HPI. Negatives on the ROS are acceptable. 
On the response in regards to severity scale of  0 - 10, severity is an element and 0 is a response but arguable a very gray area. I dont see how you could have a negative response and count any others.


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