99202-99205: Taking PFSH Level to a New Plane

Someone newly-initiated to E/M coding has a question about past, family, and social history (PFSH). They have new patients sign and date a history form, and the surgeon reviews the form. So is it ok if the surgeon’s office note includes past and social history but not family history for a new patient?

Well, your scenario about a new patient visit with documentation of two of three areas (past medical and social) qualifies as relevant PFSH.

How it functions: There are three levels of PFSH, which are none, pertinent, and complete. With no PFSH, you can reach only a detailed history level, which is associated with 99203 (Office or other outpatient visit for the E&M of a new patient). You may see this level for some surgical patients; however most likely not for complex cases such as patients thinking about bariatric surgery.

What’s relevant: For PFSH portion of detailed level of history, you need a pertinent PFSH, which is ‘a review of the history area (s) directly related to the problems identified in the HPI.

According to the guidelines, a pertinent PFSH calls for documentation of atleast one specific item from any of the three PFSH areas. CPT needs a minimum of a detailed history for 99203.

Complete PFSH: To go beyond that reach a thorough level of history (required for 99204-99205), documentation must include a complete PFSH. Whether you must have documentation of two areas or three areas for a complete PFSH depends on the type of service. As per the guidelines, for a new patient visit, you need one specific item from each of the three areas. In comparison, you’d need items from only two of the three areas for an established patient office visit.

Remember: If you figure out that a surgeon is consistently leaving out any of the elements in the PFSH, the compliance team may want to consider planning a session with your doctors to go over documentation requirements for E/M services.

For more on this and other evaluation & management guidelines, turn to a medical coding guide like Supercer.

We provide you simple, instant connection to official code descriptors & guidelines and other tools for 2010 CPT code, HCPCS lookup that help coders and billers to excel in the work they do every day.

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Does the Emirates Airlines operate on a level playing field?

Competing airlines allege that Emirates gets its fuel at a subsidised rate and the entire government machinery in Dubai bends backward to help the airline which has never posted a loss. Emirates, its critics assert, does not have to worry about high labour costs as it benefits from a migrant workforce in Dubai which comprises of workers from South Asia who are forced to work as slaves since labour laws are openly flouted in this city-state. With no corporate tax, income tax and trade unions to bother about, the airline clearly has an unmerited edge over its competitors. This is something which is contradictory to the ‘open skies policy’ advocated by the government of Dubai. They say Dubai’s famed PR machinery indirectly helps the airline by creating the desired visibility in the mindscape of consumers who are looking for cheap holidays deals to Dubai. Another charge levelled by its competitors is that the tourism machinery in Dubai works overtime to generate the much needed publicity for the airline. Other airlines do not have the financial muscle to generate such a media blitz and therefore lag behind. With unstinted financial backing from the government of Dubai, Emirates has the financial muscle to acquire double-decker A-380 super- jumbo jets from Airbus. A move that is sure to appeal to discerning business and leisure travellers all over the world who don’t search for cheap holiday deals but desire a memorable experience each time they travel. To be fair to Emirates, the airline has pursued meritocracy as the touchstone of progress. Quite a few of its senior management staff comprises of expats including the current President of the company. It has endeared itself to the swish set by setting new benchmarks in passenger comfort offering exclusive mini-suites inside its business class cabins that promise the ultimate in opulence and comfort. Emirates has cultivated itself as a brand in the developed markets of the west by sponsoring major sporting tournaments and events; thereby creating top of the mind recall amongst customers in the developed world. However, industry insiders feel that such unstinted patronage would prove to be counter-productive in the long run. It would make the airline and its management complacent, bureaucratic and unable to face the challenges of the future. Only time will whether Dubai’s rulers, blinded by ambition and greed, would pay heed to such advice or not? If they do, they will take the first step in making Emirate a highly competitive airline that can survive on its own steam and emerge as a monster brand that will last a century.

Joesmith is an expert in Search Engine marketing.Presently working in a leading travel company:Awayholidays.To know about travel & hotels in various countries like Dubai,USA,India,UK,Australia,Singapore,New Zealand & many other visit Cheap Holidays.To know details information specially about Dubai you can visit Cheap Holidays in Dubai


Taking Aviation Safety to the Next Level

It would appear, rather incongruously that air travel gets safer the more planes and passengers there are whizzing around in the skies. In 2001, for example, there were 200 commercial( 6 + passengers ) air accidents involving 1,534 fatalities and yet, in 2010, by when aircraft numbers had grown substantially, these figures had fallen to 130 and 1,103 respectively. In fact, over the last 5 years, total air passenger movements are forecast to have grown 29% from 2.13 billion to 2.75 billion in 2011 so air travel is getting relatively safer in a major way.

Of course, technological advances have a lot to do with today’s superb safety levels but the human contribution can never be underestimated. It is the teams of accident investigators working in conjunction with aircraft designers and engineers who ultimately ensure that flying gets progressively safer year after year. For their part, the inspectors and surveyors at aviation regulators like the UK’s Civil Aviation Authority also play a vital role in checking the airworthiness of both aircraft and their crews on a regular basis.

Many people may be under the impression that the CAA is full of experienced aircraft engineers who just go there to wind down prior to retirement. The reality couldn’t be further removed from this perception. The organisation is known across the globe for its world class abilities and, in order to maintain these standards, it makes a huge effort to recruit and retain highly competent and able people with an invaluable blend of experience and innovative ideas.

All the accumulated knowledge of the aviation industry since its inception is there to be found under one roof and it is continually being augmented by the cross-fertilisation of ideas.

George Monteiro is typical of the licensed aircraft engineers who now work for the CAA. He surveys aircraft and oversees log-book history to ensure they are fully compliant and up to date with procedures.

“The biggest challenge is learning to manage your own time,” he says. “There’s so much and such a variety of things to do. One day there might be the excitement of getting a new aircraft straight from the factory and having to make sure it meets all approved modifications – but it’s just as exciting meeting your daily objectives and your overall goal, which is primarily to regulate air safety.

“In doing so you appreciate what great people you’re working with. When you evaluate an aircraft and there’s nothing wrong with it, it shows that the person before you – and the person before that person – is doing an amazing job!

“That’s the key,” he enthuses. “Yes, the job does a lot for you, but it’s also about what you can do for the job – taking safety to the next level.”


Daniel Kidd writes about a range of employment, recruitment and ongoing training issues. For more information please visit Aviation Jobs

Rift Guide – Powerful Tips To Help You Level Up Faster In Drift-planes Of Telara

The finest Rift guide you will need to level up fast in Rift-Planes of Telara is the one that will help you fully comprehend the Rift quests. Comprehending all quests in Rift is essential, as it will provide you with the best weapons and armours that are going to help you level up fast and easy.

However, quite a few of these quests can be very confounding, making you take way more time and put extra work just to complete it. Thus, having a good Rift leveling guide will get you on the right path to boost your leveling speed and take you to the maximum level much quicker.

Here are a few guidelines that can help you level up quicker.

Note down important names and locations

In certain quest, you will be directed to a map that is unfamiliar to you, which most of them are quite huge. These maps are big, so make certain to make a note of the exact important locations, such as where monsters need to be killed plus the place you meet the NPC that you should speak to.

In addition be sure to make a note of the name of the NPC that you meet. You will have to talk to many NPCs in many of these quests, and having a list of their names will avoid the confounding of which NPC you will need to talk to in order to finish the quest a lot quicker.

Avoid questing in many places at the same time

Focus on questing in one zone or even one hub instead of running around doing it in two different areas at a time. This will save you valuable time and are going to significantly accelerate your speed to level up. You will be surprised how your leveling speed will increase just by doing this.

Only do the easy quests and skip the tough ones

Doing 15 easy quests instead of wasting lots of time finishing one hard quest will dramatically increase you leveling speed even more. Although experience will probably play a bigger role here, you can start by checking out quite a few quests in the list that should be skipped.

You might have been given an idea that to level up faster in Rift, you’ll need to take the same route of those who have reached the higher level, which is to finish the same quests as they did. Bear in mind that as you proceed with each quests, things will only harder, and you may not have the equal strength and ability to go through the same quests as what the more experienced players have completed.

Need more insider tips that will increase your leveling speed? Visit: Rift Leveling Guide.

You’ll find more powerful Rift guide to help get you on the right path of gaining the power leveling ability that will significantly increase your leveling speed, so you can reach the maximum level fast…very fast.

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