History of the present illness

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In a medical encounter, a history of the present illness (HPI) (termed history of presenting complaint (HPC) in the UK) refers to a detailed interview prompted by the chief complaint or presenting symptom (for example, pain).

Contents

[edit] Questions to include

Different sources include different questions to be asked while conducting a HPI, but in general they include the following:

  • onset
  • location and radiation
  • severity and character/quality
  • duration and timing
  • precipitating and palliating factors
  • progression

[edit] Acronyms

Several acronyms have been developed to categorize the appropriate questions to include:

[edit] Medicare definitions

The Centers for Medicare and Medicaid Services has published criteria for what constitutes a reimbursible HPI. A "brief HPI" constitutes one to three of the following elements:

  • location
  • quality
  • severity
  • duration
  • timing
  • context
  • modifying factors
  • associated signs & symptoms

A "extended HPI" includes four or more of these elements.[7][8]

[edit] See also

[edit] References

  • Adler H. "The history of the present illness as treatment: who's listening, and why does it matter?". J Am Board Fam Pract 10 (1): 28-35. PMID 9018660.

[edit] Footnotes

  1. ^ http://hopperinstitute.com/emt_medical.html
  2. ^ http://www.alpharubicon.com/med/medaccesshaumanao.htm
  3. ^ http://www.wemsi.org/pqrst.html
  4. ^ http://www.usask.ca/medicine/medicine/clsc.htm
  5. ^ http://dartmed.dartmouth.edu/spring06/html/student_notebook.php
  6. ^ http://www.aippg.net/forum/viewtopic.php?p=71106
  7. ^ http://www.emrconsultant.com/emr_EMcoding.php
  8. ^ http://www.usc.edu/health/uscp/compliance/tm6.html#6

[edit] External links

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