We will count four system groups: HPI, ROS, PFSH, and Exam
Each group has a specific number of defined systems within it: HPI 8, ROS 14, PFSH 3 and Exam ___
The HX (History) super group includes HPI, ROS, and PFSH. EX has only one component, Exam.
HPI score computed from these 8 elements: location, severity, timing (includes onset progression), quality, duration, context, modifying (relievers, aggravators), associated symptoms)
None = 0 elements
Brief = BRF = 1 to 3 elements (no elements = no score)
Extended = EXT = 4 or more elements (or 3 statuses of chronic illnesses)
ROS score computed from these 14 (ROS) elements: constitutional, eyes, ENT, Cardiovascular, Respiratory (chest), Gastrointestinal (includes abdomen/rectal), Genitourinary, Skin (Breast), Musculoskeletal, Neurologic, Psychiatric, Hem/Lymph, Endocrine, Allergy/Imm.
None = no elements
Problem Pertinent = PP = 1 element
Extended = EXT = 2-9 elements
Complete = COM = > 9 elements
PFSH score computed from these 3 elements: Past Medical History, Social History, Family History
None = no elements
Pertinent =PP = 1 element
Complete = COM = > 1
The HX score is computed as follows. To meet a higher level, all three components meet or exceed
HPI ROS PFSH
NONE =
Problem Focused = BRF NONE NONE
Extended Problem Focused = BRF PP NONE
Detailed = EXT EXT PP
Comprehensive = EXT COM COM
The EX score is computed as follows:
1995 rules (implement these for now)
NONE =
PF = 1
EPF = 2 - 7 (cursory level) (credit this level as default for a given system)
DET = 2 - 7 (all at detail level) (if VB or MU reports detail level)
COM = > 7 (cursory level) or 1 (at complete level) (VB or MU will report complete level)
In the ED the levels of billing (1 thru 5, 5 is more) are achieved with the following values of HX and EX. The highest level drops to the lower of EX and HX. (Example: for HX=PF, EX=COM, highest billing level is 1)
HX EX Highest Billing level
PF PF 1
EPF EPF 3
DET DET 4
COM COM 5
We will count four system groups: HPI, ROS, PFSH, and Exam Each group has a specific number of defined systems within it: HPI 8, ROS 14, PFSH 3 and Exam ___ The HX (History) super group includes HPI, ROS, and PFSH. EX has only one component, Exam.
HPI score computed from these 8 elements: location, severity, timing (includes onset progression), quality, duration, context, modifying (relievers, aggravators), associated symptoms) None = 0 elements Brief = BRF = 1 to 3 elements (no elements = no score) Extended = EXT = 4 or more elements (or 3 statuses of chronic illnesses)
ROS score computed from these 14 (ROS) elements: constitutional, eyes, ENT, Cardiovascular, Respiratory (chest), Gastrointestinal (includes abdomen/rectal), Genitourinary, Skin (Breast), Musculoskeletal, Neurologic, Psychiatric, Hem/Lymph, Endocrine, Allergy/Imm. None = no elements Problem Pertinent = PP = 1 element Extended = EXT = 2-9 elements Complete = COM = > 9 elements
PFSH score computed from these 3 elements: Past Medical History, Social History, Family History None = no elements Pertinent =PP = 1 element Complete = COM = > 1
The HX score is computed as follows. To meet a higher level, all three components meet or exceed HPI ROS PFSH NONE = Problem Focused = BRF NONE NONE Extended Problem Focused = BRF PP NONE Detailed = EXT EXT PP Comprehensive = EXT COM COM
The EX score is computed as follows: 1995 rules (implement these for now) NONE = PF = 1 EPF = 2 - 7 (cursory level) (credit this level as default for a given system) DET = 2 - 7 (all at detail level) (if VB or MU reports detail level) COM = > 7 (cursory level) or 1 (at complete level) (VB or MU will report complete level)
In the ED the levels of billing (1 thru 5, 5 is more) are achieved with the following values of HX and EX. The highest level drops to the lower of EX and HX. (Example: for HX=PF, EX=COM, highest billing level is 1) HX EX Highest Billing level PF PF 1 EPF EPF 3 DET DET 4 COM COM 5
The visual display will report the following
For # elements Level (definition) HX -------------- EPF
HPI 2 Brief (1-3) ROS 5 Extended (2-9)
PFSH 1 Pertinent (1) Exam 1(complete) Comprehensive (8/1)
3 is the Highest Billing Level supported