Medical Billing Forum
Coding => Coding => : xmikew January 07, 2014, 11:38:09 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
-
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.
-
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
-
You're smart to check and get a second opinion, mistakes do happen.
-
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