What is a Review of Systems (ROS)? 4 Example Templates in 2026

If you’ve ever had to ask a long list of symptom-related questions during a patient visit, you’ve likely done a review of systems, even if it wasn’t labeled that way.

A review of systems (ROS) is a structured way to check for symptoms across different parts of the body.

It helps uncover problems the patient may not mention on their own and supports accurate documentation and billing.

In this article, we’ll break down what a review of systems is, how to document it properly, and provide some templates you can use to save time in 2026. Let's dive in!

What is a Review of Systems? Definition & Meaning

A review of systems (ROS) is a series of questions used to identify symptoms a patient may be experiencing across different organ systems.

It’s part of the subjective portion of the patient interview and helps uncover issues not mentioned in the chief complaint or history of present illness.

The ROS can be brief and focused or extensive depending on the clinical situation. It also plays a role in coding and billing for many encounters.

Review of Systems Questions & Checklist

A review of systems is typically done through a series of yes/no questions asked during the patient interview. These questions help uncover symptoms the patient may not mention on their own.

The checklist below outlines the most common systems covered in a standard ROS:

• Constitutional – Fever, chills, weight changes, fatigue
• Eyes – Vision changes, eye pain, discharge, redness
• Ears, Nose, Throat (ENT) – Hearing loss, ear pain, nasal congestion, sore throat
• Cardiovascular – Chest pain, palpitations, edema
• Respiratory – Cough, shortness of breath, wheezing
• Gastrointestinal – Nausea, vomiting, diarrhea, abdominal pain, constipation
• Genitourinary – Dysuria, frequency, hematuria, incontinence
• Musculoskeletal – Joint pain, stiffness, muscle aches
• Skin – Rash, itching, lesions, dryness
• Neurological – Headache, dizziness, numbness, weakness
• Psychiatric – Anxiety, depression, mood changes, sleep disturbance
• Endocrine – Heat/cold intolerance, excessive thirst or urination
• Hematologic/Lymphatic – Easy bruising, bleeding, swollen glands
• Allergic/Immunologic – Sneezing, hives, frequent infections

DOs and DON'Ts for ROS

The review of systems is more than just a checklist; it needs to reflect what was actually discussed with the patient. Keep your documentation clear, relevant, and defensible with these best practices.

DOs

These tips will help you document an ROS that’s both accurate and clinically useful.

• Ask open-ended questions first – Let the patient speak freely before diving into yes/no items.

• Tailor questions to the chief complaint – Focus on relevant systems instead of going through every one in detail.

• Document relevant negatives – Phrases like “denies chest pain, shortness of breath” add value and context.

• Keep billing in mind – Don't forget any relevant ICD or CPT codes in your notes.

• Stay consistent with the physical exam – Make sure the ROS supports or aligns with your objective findings.

DON'Ts

These are common mistakes to avoid when completing the ROS section of your note.

• Don’t say “all systems reviewed and negative” unless that was truly done – This is a common audit trigger.

• Don’t copy/paste from a prior note without verification – It can lead to outdated or incorrect documentation.

• Don’t document symptoms the patient didn’t mention – Avoid assuming or autofilling unchecked boxes.

• Don’t mix up ROS and physical exam – Keep subjective and objective data clearly separated.

• Don’t overload with irrelevant info – Stick to what’s clinically meaningful for the visit.

Review of Systems Documentation Overview

A well-documented ROS should be easy to read, clearly subjective, and consistent with the rest of the note. It typically appears in the subjective portion of the SOAP note or near the history of present illness (HPI) section.

Here’s a quick guide on how to format it properly:

1. Label the section clearly

Use a heading like “ROS” or “Review of Systems” to make it stand out in the note. This helps other providers, coders, and auditors locate the section quickly.

Try to avoid burying the ROS in unrelated parts of your notes.

2. Group findings by system

List each body system with symptoms or explicitly state “denies” when relevant (e.g., “No chest pain, palpitations, or edema”).

Use clear language and avoid vague phrases. Grouping findings helps with clarity and speeds up chart review.

3. Be consistent with the HPI and PE

Avoid listing symptoms here that aren’t referenced elsewhere in the note. If something shows up in the ROS, it should match the rest of the documentation.

Inconsistencies can raise questions during audits or chart reviews, so it's a good idea to proofread before you submit the notes.

4. Indicate extent of review

If a full ROS was completed, make that clear (e.g., “A complete 14-point ROS was reviewed with the patient”).

If limited, specify which systems were reviewed. This helps determine the level of medical decision-making and supports billing.

5. Avoid generic statements

Instead of “all systems negative,” list the systems you actually reviewed and their findings.

Generic language can be flagged as insufficient or noncompliant. Be specific and match documentation to the visit type and complexity.

6. Keep it concise and clinically focused

Stick to symptoms relevant to the visit, and don’t include unrelated historical data.

Overloading this section can make it harder to read and may distract from key complaints. Brevity with clarity is best.

7. Support CPT coding requirements

A properly documented ROS helps justify the level of service billed. For example, a complete ROS is often required for higher-level E/M CPT codes, while a problem-pertinent ROS may support a lower level.

Inaccurate or missing documentation can result in insurance claim rejections, so carefully review for CPT codes before submitting your notes.

Following this format helps keep your documentation clean, compliant, and easy for others to follow.

How to Streamline Documentation With AI

Documentation has to be written meticulously, but it's often resource-intensive to do it manually. Instead, use AI Blaze to streamline documentation in any EMR and reclaim your time with patients.

AI Blaze is your personal AI assistant that helps you proofread and review your notes, generate notes in any format, summarize data, and much more.

AI Blaze works on any website or EMR and helps you streamline your documentation, no integration required.

Features

• Generate notes in any format - Quickly generate notes (like a review of systems) right in your EMR.

• Polish/reformat your notes - AI Blaze can take your rough notes and quickly rewrite them to fit guidelines & requirements and help make sure they are compliant.

• Summarize notes & text on any website - Summarize your notes or any text (including images) using AI that works anywhere you do.

• AI Blaze works in any EMR (no integration required)! - Use AI Blaze to save time right where you work without the hassle of integration.

Review of Systems Templates & Examples

Having a few go-to templates for ROS documentation can help speed up charting while keeping your notes consistent. These examples can be used as-is or customized to match the patient’s visit and symptoms.

General Review of Systems Example

This template covers the most common systems and is useful for general visits.

HEENT Review of Systems Example

Use this when the focus of the visit involves the head, eyes, ears, nose, or throat.

Endocrine Review of Systems Example

Helpful for patients with thyroid concerns, diabetes, or metabolic complaints.

Psychiatric Review of Systems Example

Use this when mental health symptoms are part of the chief complaint or history.

Review of Systems FAQ

What is the difference between review of systems and physical examination?

The review of systems is based on what the patient tells you. It’s part of the subjective portion of the note and focuses on symptoms across different body systems.

The physical exam is objective and reflects what you observe and measure during the encounter. These two sections should support each other but remain separate. Mixing them can lead to documentation issues.

What does the ROS medical abbreviation stand for?

ROS stands for review of systems. It refers to the structured symptom review you perform with the patient during the interview process.

The goal is to uncover symptoms they may not have mentioned yet. It’s often used to support clinical decision-making and billing. ROS is a key part of most patient visits.

Is review of systems subjective or objective?

The review of systems is a subjective part of the clinical note. It’s based entirely on what the patient reports during the interview.

Even if you don’t observe the symptom yourself, it belongs in the ROS if the patient mentions it.

This is different from the physical exam, which is based on your direct findings. Keeping subjective and objective data separate improves documentation clarity.

Simplify and Standardize Your ROS Workflow

A structured review of systems helps you catch important symptoms, support your clinical decisions, and stay compliant with documentation standards.

From understanding what ROS means to knowing how to document it properly, every step matters, especially when it affects coding and patient care. Use the tips, templates, and examples above to make your ROS notes more consistent and efficient.

Whether you're doing a full review or a focused one, keeping your process organized will save you time and reduce charting errors. Try using AI tools or templates to speed things up without cutting corners.

To recap, if you're looking for a way to streamline documentation, give AI Blaze a try! AI Blaze is your personal AI medical assistant that helps you take notes, review & rewrite them, summarize data, and much more (in any EMR)!