I am not a certified coder so I cannot give good solid advice. But it am curious is the 99315 being billed for the day the patient left? I'm assuming someone advised the patient that it was against medical advice. The description for CPT code 99315 - Nursing facility discharge day management; 30 minutes or less, indicates that anything under 30 minutes would be reported with this code. As long as the services performed (advising the patient it is against medical advice and writing the note) are described by the code. The best way to be sure is to contact the insurance carrier, advise them of the situation and ask if it is appropriate to bill.