Wiki ROS question

[thelton]

We have all heard the old "double dipping" rule when it comes to using the HPI for the ROS. We attended a workshop yesterday where the presenter stated "you cannot use information for the HPI for the ROS". Our MAC (Novitas) has stated it is not double dipping and I have a copy of a letter (from 1998) from an official at CMS stating there is no need for the physician to repeat the same information in both the HPI and ROS. We are trying to find where the "double dipping rule" originated. Does anyone have any information on that? Thanks!

 

[LLovett]

http://www.ercoder.com/discussion/topic.php?id=17

Double Dipping is the coder's version of an Urban Legend. The origin of the term double dipping is the Train the Trainer Conference that HCFA offered in December 1997. An attendee at the conference misquoted the speaker at the conference (then HCFA director, Bart McCann, MD) when she took the comment "cannot use one statement to count as two elements" out of context and wrote an article that was printed in Physician Practice Coder. After receiving some feedback contradicting the quote, PPC later printed a clarification but it is very short and hard to find.




It may depend on the carrier though. WPS seems to support the double dipping point of view. See below.

http://www.wpsmedicare.com/j8macpartb/resources/provider_types/2009_0526_emqahistory.shtml

Q 6. Can a physician count a single history item in both the HPI and ROS? For example, could we count "shortness of breath" as an associated sign and symptom in the HPI and respiratory system in the ROS?
A 6. A clearly documented medical record would prevent the need to "double-dip" for HPI and ROS, but WPS Medicare, in rare circumstances, could accept counting one statement in both areas if necessary.


Laura, CPC, CPMA, CEMC

 

[thelton]

Thank you!!!