r/HospitalBills • u/bvvr19 • Apr 19 '25

Hospital-Emergency No CPT codes on itemized bill

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I went to the emergency room in the beginning of March 2025 and was there for 6 hours got one bag of IV and a nurse took my blood and then I spoke to a doctor once, and then I spoke to a student doctor twice, and then I was given to packs of crackers and two packs of apple juice and another plastic cup of ice water.

I was in discharged the same day.

I requested an itemized bill, and I attached what I received. I don't see any CPT codes and when I look up the numbers next to the listed items... I can't find what the codes are for or what a fair market value of those codes would be in my area. As you can see in the picture they charged me twice for three procedures or whatever the list of things are called. I'm not sure the technical term.

I went to an in-network emergency room in a in network hospital and owe a total of $637.32.

the hospital billing department said there is some new law where you have to prove that you paid 10% of your gross income in the previous year to qualify for financial assistance, and I did not pay that much in medical bills last year so I am trying to negotiate down the bills as much as I can since I can't apply for assistance.

Does anyone know why these codes don't come up on Google? Did the hospital not give me a true itemized bill? Do I need to request another one specifically demanding their cpt codes in the itemized bill? Any help would be super appreciated thank you so much

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u/AdditionalProduct297 Apr 19 '25

You are halfway wrong here. Since this is an Outpatient claim, CPT codes DO matter. The only time they don’t and only the Revenue Codes matter is in the case of an Inpatient claim.

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u/clarec424 Apr 19 '25

Strange, because my organization would use Revenue Codes for the bill in question. But the point that I am trying to make is that CPT-4 Professional Edition won’t be much help here.

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u/AdditionalProduct297 Apr 19 '25

That part you are correct about. The insurance company has pre-negotiated rates with the facility. Even if OP knew what the CPT codes were and what the CMS Reimbursement is, that has absolutely no bearing on the amount his insurance will pay for each code.

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u/clarec424 Apr 19 '25

I agree with you 100%. Especially in the context of CMS reimbursement rates versus commercial insurance plan allowed amounts. The difference can be significant.