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Last Modified: 6/6/2020 Location: FL, PR, USVI Business: Part A, Part B

Evaluation and Management - Elements of History

Q. Can I use elements of History of Present Illness (HPI) as elements of Review of Systems (ROS) and have them both count, or is it one or the other? For example if the patient has chest pain which is “associated with shortness of breath” in the HPI, does this also count as an element of respiratory ROS?
A. The same element would only be counted once. In the example given, there are two different elements indicated (shortness of breath and chest pain), so this would count for both HPI and ROS, respectively.
Source: Program Integrity Department
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