ED Coding and Reimbursement Alert

Note slight differences in HPI rules among payers.Coders that cannot identify history of present illness (HPI) elements on ED encounter forms could be miscoding many E/M claims.Why? HPI elements are integral when selecting the appropriate ED E/M level (99281-99285, Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: ...).Avoid over- and undercoding your ED E/M encounters with this expert input on selecting HPI levels.HPI Follows Chief Complaint in Most Visits"The HPI is a chronological description of the development of the patient's present illness or injury, starting from the first sign and symptom up until the patient presents for medical care," explains Judy Newberry LPN, CPC, CCS-P, medical coding director for Insurance-Data Services in Wyoming, Mich. After the physician discovers the patient's chief complaint[s], the next step is determining the HPI, relays Peggy Bryant, CPC, CCP, professional coding audit coordinator with Dickinson County [...]