# Billing 99283 / Patient not seen by doc?



## lakeeyevicky (Jul 13, 2011)

Good Afternoon Everyone. 
I need some input from my fellow coders, particularly those of you in ER coding. 
Can a hospital ER charge a level 3 exam, 99283, if the patient left before seeing the doctor?   I happen to be that patient.
I was seen by triage nurse, history and vitals were taken then I was sent back out to waiting room. After 1 1/2 hour or so of waiting and no end in sight, I told the person on the front desk I was feeling better and left.  I am now being charged (deductible) for a 99283. Is that possible though without any type of Medical decision making?  

Vicki Durden, CPC
Manager, Billing and Collections
Lake Eye Associates


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## RebeccaWoodward* (Jul 13, 2011)

99283 requires all 3 components; Hx, exam and mdm.  

1-The ancillary staff is allowed to record PFSH and ROS; *however*, the provider is required to record the HPI. (which doesn't appear was done)

2-Although the nurse took your vitals, this still requires provider interaction (an exam).

3-No MDM

I would dispute this


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## eadun2000 (Jul 13, 2011)

lakeeyevicky said:


> Good Afternoon Everyone.
> I need some input from my fellow coders, particularly those of you in ER coding.
> Can a hospital ER charge a level 3 exam, 99283, if the patient left before seeing the doctor?   I happen to be that patient.
> I was seen by triage nurse, history and vitals were taken then I was sent back out to waiting room. After 1 1/2 hour or so of waiting and no end in sight, I told the person on the front desk I was feeling better and left.  I am now being charged (deductible) for a 99283. Is that possible though without any type of Medical decision making?
> ...



First question needed is this for pro side or facility side?  Facility side can charge for a visit without you seeing the doctor.  They can charge you (facility side) a minimum of a 99281 for vitals.  However, if they ordered an x-ray or blood work then they can code for a 99283.  If this is for physician side, I would dispute the charge.  If it is facility and nothing was done but vitals, again I would dispute the charge.  Hope this helps.


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## Mojo (Jul 13, 2011)

Hi Vicki:

I agree with Eadun2000's assessment; I would assign the same codes with the information given.

Keep us posted on the outcome after you speak to the billing CSR and/or patient advocacy rep.


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