Primary Care Coding Alert

Not accurately counting history of present illness (HPI) elements can land you on lower-level E/M codes, which could cost your practice deserved payment. Solution: Use this guide to nail down chart notes HPI elements. Count These HPI Items For coding purposes, HPI is the chronological description of development of the present illness from first sign or symptom, or prior encounter, to present, explains Mary Falbo, MBA, CPC, president of Millennium Healthcare Consulting Inc. in Lansdale, Pa. Depending on the payer, there are seven or eight HPI elements. For Medicare and Medicaid payers, the HPI elements are: " Location " Quality " Severity " Duration " Timing " Context " Modifying factors " Associated signs and symptoms. Heads up: CPT does not include duration in its list of HPI elements, so the AMA has seven elements. If you are unsure of a payers HPI element list, call your representative to check. [...]