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Pediatric Coding Alert

Reader Question:

NPs Can Use Full E/M Range

Published on Thu Oct 23, 2003

Question: Which code should I use for a nurse practitioner (NP) visit when the pediatrician doesn't first see the patient?

Florida Subscriber
 
Answer: You should report the appropriate E/M service she performs. Florida permits NPs to bill independently through collaborative physician agreements. That means she may bill any service under her own identification number.

For instance, a vacationing 9-year-old has vesicular lip eruptions from sun exposure (692.71, Other inflammatory conditions of skin and subcutaneous tissue; due to solar radiation; sunburn). Your pediatrician has no available openings, so your receptionist recommends the parent bring the child in to see your NP. She performs an expanded problem-focused history, an expanded problem- focused examination, and straightforward medical decision-making. You should report 99202 (Office or other outpatient visit for the evaluation and management of a new patient ... physicians typically spend 20 minutes face-to-face with the patient and/or family) for the NP's service.
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