Author Topic: CPT 99283 for bump on the head???  (Read 1649 times)

xmikew

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CPT 99283 for bump on the head???
« on: January 07, 2014, 08:38:09 PM »
Should a kid with a bump on the head be coded as CPT 99283? Got asked a few questions by nurse (did he pass-out, did he vomit?). Answered 'no', nurse said if those things happen, come back. Patient sent out door. No tests. No medicine.

Why CPT 99283? Am I crazy?

- Mike

DMK

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Re: CPT 99283 for bump on the head???
« Reply #1 on: January 08, 2014, 10:21:32 AM »
99283 - Emergency Dept. visit for the evaluation and management of a patient with 3 key components.

Expanded problem focused history (yes, this visit meets these criteria)

Expanded problem focused examination (did they take b/p, pulse, temp, check eyes, glands, ears? then yes)

Medical decision making of moderate complexity (yes, the questions they asked would determine if there was a concussion and if further testing would be necessary)

Sorry, but even if this was a quick visit to the ER, the injury that the patient presented with, and the decision making involved (even if, Thank God, the child wasn't badly injured) meets this code's requirements.

xmikew

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Re: CPT 99283 for bump on the head???
« Reply #2 on: January 09, 2014, 09:14:13 AM »
Thanks for the reply. I definitely appreciate it. I've had all sorts of issues with medical billing in general now I automatically assume the worst and it's hard for a layperson to justify $1000+ ED ($915 facility fee + $150 dr.) visit that included

- intake of information.
- check eyes, glands (no bp, pulse, temp) - probably because patient is 2 yrs old?
- discussed issue for 5 minutes that included...
-- straight-forward discharge

After reading the ACEP categories, it seemed this was not a 99283, but if it seems ordinary to other coders, i'll assume I'm not getting over-charged. I mean over-charged because of incorrect coding.

Thanks so much again,

- Mike

shanbull

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Re: CPT 99283 for bump on the head???
« Reply #3 on: January 09, 2014, 09:53:23 AM »
You're smart to check and get a second opinion, mistakes do happen.

Merry

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Re: CPT 99283 for bump on the head???
« Reply #4 on: January 09, 2014, 07:38:53 PM »
If you are not insured, I would suggest that you negotiate the bill at the Medicare rate. It is done all of the time.

Merry