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Thread: Can we bill for an ED patient that was triaged but left AMA before being seen by Dr?

  1. #1
    Join Date
    Apr 2007
    Spokane, WA

    Question Can we bill for an ED patient that was triaged but left AMA before being seen by Dr?

    AAPC: Back to School
    I do not do Hospital Billing currently but have been asked if it is appropriate to bill if the patient leaves the ED before being "seen" or being "treated" by the physician. I am under the impression that you can charge a low level E/M if they are triaged and then leave AMA if the documentation supports it...since the patient's vitals would have been taken, the reason for the visit would have been documented and there may have been "Standing Order" tests performed, like an EKG for chest pain or a pulse oximetry, etc. If the documentation supports the medical necessity of all tests performed and the severity of the presenting problem is clearly defined, and the ED consistently follows the same protocol for all patients who leave AMA, I think the ED should be able to bill the appropriate E/M with a status code of 07??? Any insight would be very helpful. Thanks~!
    Teresa -

  2. #2
    Join Date
    Apr 2007


    Are you talking about the facility side charges? If that is the case then no you can not bill a tier level. They are based on incident to and when the patient leaves before seeing a doctor the incident to requirements are not met.

    Laura, CPC

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