Resolved Patient leaves the exam room without seeing provider

[TonyaG_60726]

Is there a CPT to report a patient left before seen by provider (intake done by LVN)?

 

[Lori]

If you're billing for a service performed by auxiliary personnel and not performed personally by the provider, then by definition, you are billing 'incident to'. And if the patients have left before the provider has evaluated them for the presenting problem, then the 'incident to' requirements have not been met and services can't be billed, at least under CMS rules.

Appropriate Use of CPT Code 99211

The CPT® code 99211 is the only E&M code used for ‘incident to’ billing available to the physician clinic‘s ancillary staff members.

www.medicalbillersandcoders.com

Checklist for what requirements have to be met to bill 99211

https://www.ngsmedicare.com/ngs/por.../?clearcookie=&savecookie=&REGION=&LOB=Part B

Note that it states that to bill this code the "patient must be seen for a problem that has already been diagnosed with a treatment plan established by the physician/ nonphysician provider."

Also you can refer to this CMS publication for a summary of the 'incident to' rules. On page 1 and 2 that "to qualify as “incident to,” services must be part of your patient’s normal course of treatment, during which a physician personally performed an initial service and remains actively involved in the course of treatment."

https://www.cms.gov/Outreach-and-Ed...k-MLN/MLNMattersArticles/downloads/se0441.pdf

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