# Comprehensive HPI



## Sephardic (Feb 24, 2009)

I have a question regarding the HPI. I'm using the 95 guidlines. For a PF and an EPF you need 1-3 elements of HPI. For a detailed and comprehensive you need at least 4 elements of HPI. My question is what pushes you from a detailed HPI to a comprehensive HPI if they both require the same amount of elements. I've scoured through both the 95 and the 97 (and lots of other sources in between) and can't find an answer. It doesn't make any sense that they both require they same. There are 8 HPI elements altogether. Where do you draw the line?
Thanks in advance.


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## Inquisitor (Feb 24, 2009)

For me, it depends on the rest of the documentation. If the remaining history (PFSH and ROS), Exam and MDM all support CPT 99204, for instance, I call the HPI comprehensive. If remaining documentation supports CPT 99203, I call the HPI detailed.


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## RebeccaWoodward* (Feb 24, 2009)

Have you taken a gander at this website?  Lots of terrific (free) information.

"The Comprehensive History is the highest level of history and requires a chief complaint, an extended HPI (four HPI elements OR the status of three chronic or inactive problems - if using the 1997 E/M guidelines), plus a 10 system ROS, plus a Complete PFSH ." 

http://www.emuniversity.com/ComprehensiveHistory.html


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## Sephardic (Feb 25, 2009)

Thanks! That really helped.
I was about ready to rip out my hair.


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