tci ED Coding & Reimbursement Alert - 2001 Issue 12

The Scoop on Double Dipping: Its OK To Count Systems in Both ROS and HPI

  ED coders have long argued whether an organ system may be counted in both the history of present illness (HPI) and the review of systems (ROS) portion of emergency department E/M services. Both are components of the history-taking key element, with the HPI covering the development of symptoms that caused the patient to come into the ED, and the ROS an inventory of body systems identifying additional signs and symptoms that the patient is experiencing or has experienced.   For example, a patient arrives at the ED with upper respiratory infection symptoms. When recording the HPI, the...

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