Oncology & Hematology Coding Alert

Question: Our nurse injects a patients allergy medication. Can we charge for a nurse-only visit (99211) and administration/injection (90780) even though we are not that patients allergist? Also, which diagnosis code should we report?

Alaska Subscriber
Answer: You cant bill for 99211 (Office or other outpatient visit) and 90780 (Intravenous infusion for therapy/diagnosis, administered by physician or under direct supervision of physician; up to one hour) if the patient visits your office primarily for the injection. In your case, you may have a problem reporting the injection because you didnt provide the medication, which means you cant bill for the medication as well. Therefore, you should report 99211.

The diagnosis also depends on the patients reason for visiting your practice. If the patients primary reason for visiting is stomach cancer (151.x), for instance, and the allergy condition say, allergic rhinitis (477.x) is secondary, you should report 151.x, followed by 477.x.