# 3 chronic illness = automatic 4 HPI



## DeniseDenise (Apr 25, 2008)

3 chronic illnesses = an automatic 4 HPI, is this the standard for 95 and 97 guidelines?

Thanks!


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## valleycoder (Apr 25, 2008)

*Per 97 guidelines*: an extended HPI consists of at least 4 elements of the HPI or the status of at least 3 chronic or inactive conditions.  
*Per 95 guidelines*: an extended HPI consists of 4 or more elements of the HPI.  The medical record should describe four or more elements of the present illness (HPI) or associated comorbidities.


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## Erica1217 (Apr 27, 2008)

It also depends on the carrier.  

Mine has said you can count the status of 3 chronic conditions whether you are using 1995 or 1997 guidelines. 

http://www.medicarenhic.com/faq_det...t/Consultations&searchphrase=&faqpagesize=100


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## Belinda Frisch (Jun 25, 2008)

*Status*

"Status" is the key to this. Make sure it is more than a list of 3 ccs. This link to the CMS-approved Highmark Medicare audit form allows for either or. Though I have seen the argument that if you use the 3 cc to support a comprehensive HPI you must adhere to the 97 DGs (bulleted) examinations, I don't know that to be 100% true. It makes sense, but currently it's an either/or situation and, I think, open to interpretation.

http://www.highmarkmedicareservices.com/partb/reference/pdf/scoresheets/8985.pdf


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