Wiki ER Visit

[Kareng310]

Can a 99284 be billed if you only had a triage visit and left before seeing a doctor due to a long wait?

 

[TThivierge]

Hi Kreng
No I would not give that visit 99284. First Id talk to management if there is a rule. Or give it the lowest CPT 99282 for atleast person getting vitals done But did they leave after lab or xray or none of that was done either ?Also did you put Z53.8 AMA on the claim if nothing done but vitals?
Well that is my advice
Lady T

 

[CBLENNIE]

Or give it the lowest CPT 99282 for at least person getting vitals done

The lowest E&M for an ER visit is actually 99281-Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional. The following additional information is provided by EncoderPro for Payer Professionals:

• For the lowest level of care, 99281, services can be performed by clinical staff and must be face-to-face. The presence of a physician or qualified clinician is not required, but services are performed under their supervision.

Since the patient left before being evaluated by a physician or NPP 99281 may work since it does not require the presence of a physician or NPP, but the work of the clinical staff performing the triage services would still need to be performing under the supervision of a physician or NPP.