I hope someone can help me. After many years of coding I have a nagging question in my mind concerning the counting of the location, duration, severity, etc in the HPI.
When I was studying, I thought I read that no matter how many Complaints each complaint had it's own HPI. You could add these together to get the number of HPI. An example would be:
1) complaint: Low back, pain= 2 HPI,
2) complaint: rt arm, rash,2 days =3 HPI
Total for this patient would be: 5 HPI.
Then I went to work for a company and was told that each complaint had its own HPI and that you don't add these together that if one of the complaints didn't have a total of 4 elements (location, duration, etc.) that could be counted then you wouldn't have a 99203 for a new patient since you need all 3 (HPI, Exam and MDM) for this code. If all three complaints, singly, only had 3 bullets you could add them together to get 9 HPI! Now that the EMA (EMR's) have begun to surface, I notice that the programs add the bullets of HPI together and sometimes with 2 complaints there will be a total of 8 bullets.
SOOOOO now my question is which is right:
1) add all the bullets from every complaint together to get a total HPI
2) are each complaint individual and the bullets can not be added together to get 4+ for the higher level of HPI.
Any responses, as soon as possible, is much appreciated, Thanks for your help.
When I was studying, I thought I read that no matter how many Complaints each complaint had it's own HPI. You could add these together to get the number of HPI. An example would be:
1) complaint: Low back, pain= 2 HPI,
2) complaint: rt arm, rash,2 days =3 HPI
Total for this patient would be: 5 HPI.
Then I went to work for a company and was told that each complaint had its own HPI and that you don't add these together that if one of the complaints didn't have a total of 4 elements (location, duration, etc.) that could be counted then you wouldn't have a 99203 for a new patient since you need all 3 (HPI, Exam and MDM) for this code. If all three complaints, singly, only had 3 bullets you could add them together to get 9 HPI! Now that the EMA (EMR's) have begun to surface, I notice that the programs add the bullets of HPI together and sometimes with 2 complaints there will be a total of 8 bullets.
SOOOOO now my question is which is right:
1) add all the bullets from every complaint together to get a total HPI
2) are each complaint individual and the bullets can not be added together to get 4+ for the higher level of HPI.
Any responses, as soon as possible, is much appreciated, Thanks for your help.