ER Billing – CPT/Level Excessive?
Hello,
Looking for help. I think a nearby hospital coded a recent visit wrong and I'm being overcharged as a result.
My child went to urgent care with Croup and Strider symptoms. They administered Epinephrine breathing treatment via mask and gave an oral steroid. These treatments resolved the issue. They were about to close for the evening and recommended a transfer to the ER so he could be put on blood oxygen monitor for two hours. We accepted. I have no issues with the billing from the urgent care.
At the ER, we were immediately directed to the waiting room. My child was never monitored. We stayed in the waiting room for the two hours. After the two hours was up, they called us to the room where they take vitals. The ER doctor listened to his breathing for less than 10 seconds, said it sounds like the urgent care treatment worked, then discharged us.
We were charged for a level 3 99283 ER visit. I've been reading the criteria for each level and I don't think level 3 is justified. I think it should be level 1 or 2. They did no examination or diagnosis. Administered no care, dispensed no drugs, wrote no scripts, made no decisions, and made no recommendations for after-care. We sat in a waiting room and then were discharged. I don't dispute they rendered some services and I owe for that, but I don't think they have the justification to call this level 3.
Before I start escalating this with the provider, wanted to get some opinions if I am at all justified in pushing back.
This hospital has a history of overzealous billing. They recently billed 4 reading charges on 2 MRIs. Billing department said that's fine/normal. I've had this done annually for 10 years so I knew it was not. When I called the ordering doctor's department they said it was wrong and sent it back to billing to redo. And on this ER visit they charged for an oral steroid, which they did not administer. So it's not out of the question they got the level wrong also.
submitted by /u/sasquatch_melee
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