Pediatric Coding Alert

Hint: The 'nurse visit' code isn't just for nurses.Insurers know that 99211 is frequently misused making it a target on audits. Protect your practice from 99211 payback requests by addressing these 'nurse visit' code myths.Who Can Use 99211?Myth: You should use 99211 only for nurse visits.Fact: Physicians, nurse practitioners, and physician assistants can use 99211 as well as nurses. The level of history, however, associated with 99211 often means that when a healthcare professional provides the service, the components that are medically necessary to be performed will often be higher than 99211.What Does 99211 Require?Myth: You should automatically use 99211 to bill for allergy shots and vaccinations if the provider did not provide any other service.Fact: You can't report 99211 for just an allergy shot or vaccination. To bill 99211, the patient must have a problem that requires a nurse assessment. Documentation must indicate the concern, such as a missed [...]