If you are looking to bill the admit codes, 99221-223, you could do the following-
1) Can the MD atleast get some vitals? I would think that in lieu of the MSE, he could comment about his psychosis and why he cant respond. That in itself is part of the exam. The patient is obvisouly not oriented, so that could be a bullet there.
If you cant/dont use one of those for the exam and you have absolutely no exam elements at all, then you can bill either a 99499 with documentation (which is what Medicare says to do) or you could bill the 9922_ with 52 mod for some other carriers. I have also heard of people bumping to the subsequent category (99231-3) but I dont personally. The intent of visit isnt a subsequent
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