# Left AMA



## sbethea

What dx code do you use when patients leave after triage or against medical advice w/o being seen by a clinician. I always assumed that you would just code the signs and/or symptoms but someone is telling me differently.


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## mitchellde

I assume you are billing for the facility as a physician could not bill for this patient.  If you are billing for the facility then you would only have the symptoms to use for the dx code.


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## mmoore70

If they were just triaged and then left AMA or LWBS without being brought back to room and seen by physician, we usually code these as V64.2. 
If patient is brought back to room and physician does exam and orders lab/radiology and then patient leaves AMA prior to a diagnosis being reached, we code the signs and symptom.


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## sbethea

Yes, I was referring to the facility. Thank you!!!


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## vj_tiwari

Hey ,

Patient leaving emergency room without receiving treatment 
Coding Clinic, First Quarter 1999 Page: 13 to 14 Effective with discharges: February 15, 1999  

Question: 

A patient comes into the emergency department complaining of sore throat and fever. A nurse interviewed the patient and recorded his vital signs, history and complaints and told the patient that the physician would be in shortly to examine him. A few minutes later when the nurse came back to check on the patient, it was discovered that the patient had eloped without being treated or seen by the physician. How should this be coded? Some coders have been assigning V15.81, others have assigned V64.2, and others the presenting signs and symptoms. 

Answer: 

For internal data collection purposes only, the healthcare facility may choose to code the signs and symptoms that the patient actually presents with to the emergency department. Please note that the assignment of codes does not constitute authorization to bill. Individual payors may have different requirements regarding whether or not a bill may be submitted for this encounter. 

Hope this helps!!!

VJ


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