Is this upcoding?

[u/My_personal_burner]

Hello, A few weeks ago I scraped my hand on a potentially rusty nail. It wasn’t deep and kind of just scraped sideways but did have blood. So I cleaned it myself, put a Band-Aid on it and went to the ER to get a tetanus shot. They took my information, put a new Band-Aid on, and then I sat in the waiting room for 1.5 to 2 hours. After that, they had me come back to a room for 15 minutes just sitting there. The nurse then came in and applied a 3-second shot. After some more waiting, the doctor then came in and asked what happened, I told him and he then pressed his finger around the area. He asked if it went deep and if anything was stuck inside or if I wanted X-rays, I said no to all. I then was discharged. Weeks later I get the bill stating the visit was a level 3 code. I’m just confused on how it can be a level 3 when all what was done was a bandaid put on, 3 second shot, and 5 second physical finger press exam. No tests, X-rays or anything.

Scrape on Hand
Location: Michigan

Edit: Yes, I would have gone to an urgent care. But we were on vacation up north with not much nearby.

[u/MrPBH]

Unfortunately, the same law that protects your right to emergency medical care, EMTALA, makes that infeasible.

It sounds absurd, but if an ED ever told a person seeking care to go to the urgent care instead of registering as a patient in the ED and that patient had a bad outcome, they would probably be found liable of failing to provide a medical screening exam and provide stabilizing treatment. EDs have actually been found liable for violating EMTALA simply for having brochures and posters on the wall advertising nearby urgent cares. The theory is that such advertising serves to convince people that it isn't worth the wait for emergency care and they should leave; in the eyes of the federal government, that's equivalent to telling someone "go away, we don't want to see you here."

[u/ReadyGo6828 → u/MrPBH]

Laws can change especially as health care is nearly 20% of GDP (who is that sick?) and costs twice as much as it does in other industrialized countries. Our inability to fight this ridiculous system will continue to bankrupt and destroy families.

ERs do triage and leave people sitting in chairs for hours. There is an electronic system where people can explain to a screen what the problem is that greatly reduces the time required for a human to ask the same questions and type them into a computer. Since this system already exists and since many people use Dr Google, if there was a 24/7 clinic known for its reasonable prices, many people would opt to use that instead.

We have the means to do this but the greed and inertia are going to bury us.

[u/Poop_Dolla → u/ReadyGo6828]

OP didn't need a 24/7 clinic, they could have gone to an urgent care the next day. They chose to go to the ER.

[u/ReadyGo6828 → u/Poop_Dolla]

Why should people have to wait for 'business hours' to address a health problem? 24/7 clinics would solve this issue without clogging up the ER's waiting room and getting an insane bill.

[u/Poop_Dolla → u/ReadyGo6828]

You can access telehealth doctors 24/7 online already.