Wiki Validating Fam Hx

[clopez]

I just finished an audit for a group of Hospitalist where few of them documented "Fam history of Diabetes" or Fam history of Heart Disease.

I recommend the Chief to document the specific family member with the condition like

" Mother with diabetes or Father with heart disease" in order to get credit.

The guidelines give examples where specific family members are identified but don't have literature that says not ok to document without the specific family member.

Am I being too stringent? The chief told me his never gotten this feedback before

 

[OCD_coder]

I make it a recommendation to identify the family member within Family History so that we don't have a risk of not receiving credit by a carrier.

The reason being I have had providers document family members that were not blood related "step-son" "step-father" etc. without realizing they did so. When calling it to their attention they just simply did not realize what they had done.