# location



## LWESTHAUSE (Nov 9, 2011)

Just wondering how everyone else counts elements of HPI as i have conflicting information.   How many elements does everyone else get out of this note below and do you count arms, legs, back and stomach as 1 or 4 for location.   Is this really 6 elements or 3 being location 1 counting all areas as 1, duration 1 and modifying factor 1?

If a note says patient has a rash on arms, legs, back and stomach for 5 days using hydrocortisone without improvement.  

Thanking you in advance.


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## FTessaBartels (Nov 9, 2011)

*Location counted once*

I tend to count each element only once, however I have heard that certain payers will recognize each location as a separate element of HPI.  

I'd be inclined to do this if there were SEPARATE problems.  For example a rash on the arm, and a sprained ankle (then I could be persuaded to count TWO bullets for location).

I would count the example you give as 3 HPI elements: Location, duration, modifying factors

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## LWESTHAUSE (Nov 9, 2011)

yes it helps alot - that is how i tend to want to do it as well but i listened to a web conference of Inga Ellzey's and it shows that each are counted as a separate elements.  Please if anyone else has any imput please let us know what your interpretation is on this. 


Thank you, 

Linda


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## DeeCPC (Nov 18, 2011)

I usually agree with Inga Elzey but not on this...to me it is one rash.  If there was a raised rash on the torso and a weepy rash on the arms then I might consider these as seperate elements.

Dee
CPC, CPCD, CPMA


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