Primary Care Coding Alert

Question: When a patient comes in for allergy injections -- and that's all the nurse sees the patient for -- what is the proper billing procedure? I am suggesting CPT 95117 . Should we also use 99211? Iowa Subscriber Answer: You should report 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician ...) in addition to multiple allergen injections (95117, Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections) if the nurse performs a minimal E/M service related to the immunotherapy. Providers may bill for a nurse-only 99211 when dealing with clinical issues surrounding allergy injection administration, according to the Joint Council of Allergy, Asthma and Immunology (JCAAI). The nurse must document the medically necessary E/M service that she provided. The JCAAI suggests the service could represent directing a nurse who [...]