DecisionHealth, DecisionHealth - 2012 Issue 4 (April)

WPS: Status of 3 chronic conditions accepted with 97 guidelines only

Practices that followed WPS carrier instructions to document extended history of present illness (HPI) with three or more chronic conditions when using the 95 E/M guidelines must retrain staff to follow the “four or more elements” requirement to avoid lost payments. If physicians choose to use the 97 guidelines, they can document the status of three chronic conditions but must record whether those conditions are improving, stable or declining.

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