Scheduled patient leaves


Ellenwood, GA
Best answers
I'm hoping someone can help me with this one!
We had an established patient come in for a follow-up appt. The patient was taken to the back, a part of the H & P was performed by the MA. The physician was seeing another pt. which took a great deal of time. The patient did not want to wait any longer and decided to leave without being seen by the physician. Is CPT 99211 justifiable in this case? If not, what is the most appropriate way to bill for this service.

Toni Jeffries CPC CPC-H
The overriding requirement to any billable service is that there must be documented medical necessity. The H&P documented was not medically necessary outside of a face-to-face visit with the provider. Since this information is documented, it can be reviewed, signed and noted at the next visit (with any changes documented) to be included at the next visit, however it is not billable.
From a customer service standpoint, imagine how the patient would feel if they took time from work and arranged to be at the doctor's office, waited a very long time and then could wait no longer. Then, in addition to the inconvience involved, either they or their insurance received a bill for this; you would have a very dissatisfied patient.

Helen L. Avery, CPC,CHC
Senior Coding and Revenue Cycle Consultant