07-25-2017, 01:28 AM | Community Wiki

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when patient leaves the E.R. without being seen?

  1. Default when patient leaves the E.R. without being seen?
    Medical Coding Books
    Can some1 tell me how this should be handle. Is it a no charge when the patient comes into the E.R. and then leaves without seeing the doctor? Also, in this case, what ICD9 would I use?

    Facility side & physician side answers please!!! Thanks

  2. #2
    On the facility side...you can charge a small ER fee as most patients have at least been triaged. You use the diagnosis of the presenting problem when billing.

    On the physician side...you can not charge, if the physician never saw the patient. If the physician did see the patient and the patient left before being discharged, you may be able to charge based on the documentation that was done by the provider. Make sure they notate that the patient left before final disposition and again use the diagnosis of the presenting problem when billing.

    If the patient was not seen by the provider, you should still put in a "ER Walk" no fee charge for tracking purposes. Most ER's like to keep stats on patients that leave before being seen, so they can improve on their ER wait times. Hope this helps a little...thanks.

  3. #3
    From the facility coding side, I have always used the ICD9 code V68.81 -referral of patient without examination or treatment. Hope this helps.

  4. #4
    I recently heard that if the ER patient only got triage & not seen a physician then the facility can't charge for a visit?

  5. #5
    You can bill 99281 for the facility when the patient has been triaged.

  6. #6
    our hospital does not charge for facility we code cc and dx V64.3

  7. #7
    Our facility does charge a minimal level for triage time and we code with a dx code of V64.2.

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