Wiki Question Regarding HPI Element

ch81059

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Hi All,

I have this progress note and it indicates in the HPI that the patient is having abdominal pain that is worse "after a long day at work". Would you consider this to me timing or modifying factor? The sample of the note is below. Thanks!

Progress Notes
HPI
XXXXXXX is 35 years old and presents with a history of worsening midepigastric abdominal
pain. Patient carries a diagnosis of irritable bowel syndrome but recently she has been noticing increasing pain and swelling in her upper midline particularly after a long day at work. She was seen in the emergency room and was noted to have an upper midline ventral hernia. This was confirmed by her primary care physician, and she was subsequently referred here for evaluation.
 
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