# double dipping in the ED



## ptrautner (Nov 17, 2010)

Can someone finally clarify if you can or cannot double dip, i was trained eons ago that absolutely not, now i am reading that you can and it is an urban legend. Can you count elements for ROS from the HPI because doc did not fill out enough ROS to capture the level he should have?  I was trained to downcode can someone fill me in on the final rule on this?


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## akuley (Nov 18, 2010)

*double dipping in the ER ...*

you can use elements from the HPI as ROS however you can NOT use them as both HPI AND ROS...you have to use as one or the other


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## turtle818 (Nov 18, 2010)

Same here. You can use elements of the HPI for the ROS but they cannot be used for both.


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## ptrautner (Nov 18, 2010)

*Re: Double dipping in the ED*

Can either of you tell me officially what document states that?  We are having a debate at my new place of employment, that is how i was taught always that you cannot, my staff here were taught that they can, to change the policy i would need to have something official to show the manager. Can either of you help me out there?

Appreciated


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## trackoch (Nov 18, 2010)

*Double Dipping*

The ACEP website has a letter from Medicare stating you are allowed to 'double dip' for the ER notes.


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## ptrautner (Nov 19, 2010)

i did read that on ACEP, still seems room for debate as several facilities are adapting best practice to not double dip.


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## Mojo (Nov 19, 2010)

ptrautner said:


> Can someone finally clarify if you can or cannot double dip, i was trained eons ago that absolutely not, now i am reading that you can and it is an urban legend. Can you count elements for ROS from the HPI because doc did not fill out enough ROS to capture the level he should have?  I was trained to downcode can someone fill me in on the final rule on this?



This question was posted on the Highmark Medical Services Website:

15.When scoring the review of systems (ROS), can you use the systems addressed in the history of present illness (HPI) elements or is that "double dipping"?

ROS inquiries are questions concerning the system(s) directly related to the problem(s) identified in the HPI. Therefore, it is not considered "double dipping" to use the system(s) addressed in the HPI for ROS credit.

Date Posted: 10/16/2009, Date Reviewed/Revised: 08/30/2010


https://www.highmarkmedicareservices.com/faq/partb/pet/lpet-evaluation_management_services.html

HTH


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## ptrautner (Nov 23, 2010)

Thanks Mojo!


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