# HPI and ROS Double Dipping



## mony94803 (Jan 11, 2013)

E/M Guidelines

I have a encounter that states:

HPI: Patient complains of chest pain for 2 weeks which is dull in nature.  No SOB 


Can I count chest pain twice?  One element for location in HPI and one element for Cardiovascualr ROS?  I'm really confused as searching on the web states yes we can double dip and others state we can't.

Palmetto website states "Documentation cannot be used twice uner the History Component.  This is referred to as "double dipping".  Example: Allergies may be used under the ROS(Allergic/Immunolgic) or under past history".  

Does the term "History Component" mean all components? (i.e. CC, HPI, ROS and PFSH).  Do you know where I can get an answer?

Thanks
Simone Shofner, CPC:


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## tmorgan808 (Jan 11, 2013)

I was always taught that it is "double dipping" to use it twice. I want to say I learned that in an AAPC webinar but I cannot remember for sure.


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## sumeet_lawhare@yahoo.com (Jan 12, 2013)

mony94803 said:


> E/M Guidelines
> 
> I have a encounter that states:
> 
> ...




take chest pain only once. cause if you take it twice it double dipping... and y we cant double dip cause  in some cases .. if you consider same documentation in 2 places it rises your level so that's not ethical.


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## mony94803 (Jan 14, 2013)

*Double Dipping*

Thank you for yoru answer.  Do you know where I can find this information from CMS?

Thanks
Simone


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## lphillips (Jan 23, 2013)

mony94803 said:


> E/M Guidelines
> 
> I have a encounter that states:
> 
> ...



You can break it down like this:

cc: Chest pain

HPI:
duration = 2 weeks
quality = dull in nature

ROS:
respiratory = No SOB

This way you are not "double dipping" as you put it. ROS can be abstracted/taken from the HPI.


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