Past medical history

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In a medical encounter, a past medical history (abbreviated PMH) [1] is the total sum of a patient's health status prior to the presenting problem.

Contents

Questions to include

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

Acronyms

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

In prehospital medicine, namely EMS, the acronyms SAMPLE or CHAMPS are used.


Medicare definitions

The Centers for Medicare and Medicaid Services [5] has published criteria for what constitutes a reimbursable PMH. A PMH is considered one of three elements of the "Past, Family, and Social History" (abbreviated as PFSH): [6]

A pertinent PFSH consists of at least one of the three components; a full PFSH consists of two or three components for an established patient, or all three components for a new patient visit. [6]

CMS required history elements [7]
Type of history CC HPI ROS Past, family, and/or social
Problem focusedRequiredBriefN/AN/A
Expanded problem focusedRequiredBriefProblem pertinentN/A
DetailedRequiredExtendedExtendedPertinent
ComprehensiveRequiredExtendedCompleteComplete

See also

References

  1. Swartz, Mark (2002). Textbook of Physical Diagnosis: History and Examination . Philadelphia: Saunders. pp.  19–23. ISBN   1-4160-2405-0.
  2. "Enlarged Tonsils, Adenoids And Allergies May Affect A Child's Bite, Facial Appearance And/Or Behavior". ScienceDaily. September 7, 2004.
  3. "Useful Acronyms for Facilitators and Students". Heritage College of Osteopathic Medicine.
  4. HPI (history of present illness) Archived 2006-10-04 at the Wayback Machine
  5. "Home". 18 November 2016.
  6. 1 2 "Evaluation and Management Coding and Electronic Health Records". emrconsultant.com.
  7. "Evaluation and Management Services Guide" (PDF). www.cms.gov. December 2010. Archived from the original (PDF) on 2012-04-11. Retrieved 2011-02-27.