# HPI statement "Patient Feels Fine"



## ollielooya (May 18, 2012)

Does this statement qualify for *quality* as an element in HPI?  I think not, but in reading a descriptor as "what kind", sharp, dull staiing, burning, irritating, throbbing, aching constantly, intermittent---the fact that the patient is devoid of these makes me wonder if "patient feels fine"could be plugged in.  Might be a case of my "over-thinking" again.  I know this has been addressed on the forum before, but couldn't pull it up.


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## LindaEV (May 18, 2012)

I'm curious what the cheif complaint is...and if the patient feels fine what the purpose of the visit is. If it is a follow up to something, and that was all i had, I would give 1 HPI element of quality.


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## FTessaBartels (May 18, 2012)

*I tend not to count this*

First, I work in pediatrics, and more specifically with pediatric surgeons.  We only see patients who have some definitive, potentially surgical, problem. 

That being said, I usually don't count such nebulous statements for any of the HPI elements. 
What would I count as quality?  Let's look as specifics rather than generalities ...
Complaint F/U fracture -  open vs closed or "greenstick" 
complaint DM - type 1 or type 2, controlled or uncontrolled 
Complaint hernia - reducible or incarcerated or strangulated
Complaint rash - red, itchy, patchy, scaly

However, I think LindaEV has a valid point. If I could be persuaded to count is as a "negative" report, I *might* count it as negative for assoc signs/symptoms.
If the patient is coming in for a F/U of DM2, for example, and the only HPI is "patient feels fine" then I think it *might *count for quality.  Still, if you're only going to get ONE HPI element, I'd rather see duration .... e.g. Last seen 2-13-12, and patient feels fine.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## ollielooya (May 18, 2012)

*further clarification to one of your posts?*



FTessaBartels said:


> However, I think LindaEV has a valid point. *If I could be persuaded to count is as a "negative" report, I might count it as negative for assoc signs/symptom*s.
> F Tessa Bartels, CPC, CEMC



Please, Tess can you elaborate and/or furnish an example to the "negative report" aspect?
I took the liberty to bold and underline the part in question.


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## Tonyj (May 21, 2012)

ollielooya said:


> Please, Tess can you elaborate and/or furnish an example to the "negative report" aspect?
> I took the liberty to bold and underline the part in question.



I would count it as 1 point for severity. See below "coding tool for history" I've attached the link. 
Severity;	Intensity, degree or measure of a symptom.  On a scale of 1-10, how severe is the pain?  Ex:  mild pain, fever 101, my blood sugar is 175, feels well, no complaints, worse pain I've ever had.

http://www.codingbuzz.com/forms.html
http://www.professionalcodingservices.com/


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## FTessaBartels (May 24, 2012)

*I count negatives*

I could negatives ("patient denies" or "no x, y, z") as associated signs/symptoms.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## natraj21 (May 31, 2012)

FTessaBartels said:


> I could negatives ("patient denies" or "no x, y, z") as associated signs/symptoms.
> 
> Hope that helps.
> 
> F Tessa Bartels, CPC, CEMC


Hi,

   How should be the associated signs and symptoms?
 should it be related to cheif complaints related system or anything other than that?
 Eg: Pt came with headache and he has palpitation, there is no trauma or injury..  

 in this case can we consider palpitation as associated sign.

Thanks in advance

 Natarajan Chellamuthu, CPC.


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