How do I dispute an emergency room bill?

Start by requesting an itemized bill and your UB-04 form from the hospital. Compare the CPT billing codes to your medical records, and look for upcoding, duplicate charges, or services you did not receive. MedicalBillReview.net can review your bill for free and identify errors you can formally dispute.

Is the ER bill review completely free?

Yes. MedicalBillReview.net provides a completely free, independent review of your emergency room bill. There is no cost to you at any point.

What is upcoding on a medical bill?

Upcoding is when a hospital bills for a higher level of care than was actually provided. For example, billing CPT code 99285 (the highest complexity ER visit) when the actual visit was a routine 99282. This is one of the most common and costly billing errors on ER bills, and it is something we specifically check for in every review.

What does the No Surprises Act cover for ER bills?

The No Surprises Act protects patients from unexpected out-of-network charges at in-network facilities, including emergency rooms. In most cases, you cannot be billed more than your in-network cost-sharing amount for emergency care, regardless of which doctor treated you.

What billing errors are most common on ER bills?

The most common ER billing errors include: upcoding (billing a higher level of care than provided), unbundling (charging separately for services included in a flat rate), duplicate billing (charging twice for the same service), and errors in medication quantities or supply units.

How do I get an itemized bill from a hospital?

You have a legal right to an itemized medical bill. Contact the hospital billing department and specifically request an itemized statement and the UB-04 claim form. Under federal law, hospitals must provide your medical records within 30 days of a written request.

CPT Code 99284: Level 4 Emergency Room Visit Explained

CPT code 99284 represents a "Level 4" emergency department visit, indicating a high level of medical decision-making. This is one of the most common codes used in ER billing, but it is also one of the most frequently misapplied. Understanding the clinical requirements for a Level 4 visit is key to auditing your bill.

What Qualifies as a CPT 99284 Visit?

A 99284 visit typically involves a problem of high severity that requires urgent evaluation but does not pose an immediate threat to life or physiologic function. It requires a detailed history, a detailed examination, and medical decision-making of moderate complexity.

Typical situations that justify a Level 4 (99284) code include: chest pain requiring workup (EKG, troponin) but no life-threatening cause found, complex lacerations or fractures, severe abdominal pain requiring imaging, and infections requiring IV antibiotics.

CPT 99284 vs. Other ER Visit Levels

Code	Level	Typical Visit
99281	1	Very minor issue, minimal evaluation
99282	2	Low complexity, limited testing
99283	3	Moderate complexity (sprain, minor infection)
99284	4	Higher complexity, broader workup needed
99285	5	Highest — serious conditions, intensive management

When 99284 May Be Incorrectly Billed (Upcoding)

You had a simple UTI or minor infection treated with oral antibiotics
Your visit was for a minor injury that only required X-ray and splinting
The doctor spent minimal time with you but billed for extensive evaluation
You were discharged quickly with no significant findings

How to Check If Your 99284 Bill Is Correct

Request your medical records — specifically the Physician Note and Nursing Notes
Look at what tests were ordered (labs, imaging) and what was found
Compare the documented complexity to the Level 4 criteria above
If the documentation doesn't support Level 4, you have grounds for a dispute

Get a free CPT 99284 billing review →