# HPI element (location)



## Tonyj (Aug 23, 2012)

Pt presents with complaints of iron deficient anemia. I normally use blood as the location for my HPI elements but recently I have been informed that I could not use blood as the location due to the fact that it is a condition not location.

Could anyone shed some knowledge on this matter? Is this documented anywhere? I code for Hem/Onc and I see quite a few blood disorders.


----------



## OCD_coder (Aug 23, 2012)

I too work for Hem/Onc clinics.  Anemia is a condition, but it is also part of the Hemat organ system thus we defend it as "location" for the HPI elements.  It also can be considered in the Consitutional organ system as it generally presents with weakness.  Hard to define a specific "location" with weakness when it is felt over the entire body.  Deficiency can be given credit to severity.  It is no different than a patient who presents with allergies, sometimes it is a systemic presentation and not specific to a pin-pointable "location".

	History of Present Illness (HPI) – the HPI is a chronological description of the development of the patient's present illness from the first sign or symptom or from the previous encounter to the present .  Includes the following elements and the questions you may be asking to get the appropriate answer:
o	Duration- How long has it been going on?  When did it start?		
o	Location-Where?  Does it radiate?
o	Severity-How bad?  On a scale of 1-10?
o	Quality-How does it look or feel?
o	Timing-How often? When does it happen?
o	Context-How did it happen?   What were you doing when it started?
o	Modifying factors-What makes it change?  Have you tried anything to treat it?
o	Signs and symptoms-What else is happening?  Are you also experiencing ________?


----------



## Tonyj (Aug 23, 2012)

Thanks for the response and I agree but recently during a seminar I attended I had been informed by our MAC that blood is considered a condition not location. That's a dilema for me. I could argue the point of the hemat organ system but I was hoping to avoid that, as well as any ensuing pre and post payment reviews.


----------



## FTessaBartels (Aug 29, 2012)

*Not location*

I would not count "blood" as a location.

You'll have to come up with four OTHER elements of HPI.

Hope that helps.

F Tessa Bartels, CPC, CEMC


----------

