Chemo Coder
"Can a chemo teach be charged anything higher than a 99211? (A NP does these.)"
I agree with OCD_Coder, "There is no E&M service inclusive to chemo or therapeutic administration codes as the NCCI manual clearly states that it only applies to minor procedures. The global status code for the administration codes is an XXX; meaning it's not a "minor" procedure and they do not have an E&M service included in the service. We have been billing our NP's for years and have never had any carrier tell us differently when we specifically ask on this issue. I agree most visits are typically 99214 and possibly 99215's based on their typical time of 45-60 minutes. If chemo-administration is performed on the same DOS, a 99211 cannot be billed regardless of how well it's documented. This allows for the proper E&M to be billed."
If chemo teach is what the patient is coming in for, yes, most of the time the NP does these, they can chart a 99211 which states, "Office or other outpatient visit for the E&M of an established patient, that may not require the presence of a physician. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these. Although we know that chemo teaching does run more than 5 minutes, because the physician is not providing a history, exam and and MDM, 99212 through 99215 would require meeting 2 of 3 key components which a nurse practitioner is not doing, therefore, this is the only code you can use with a V65.49 "other specified counseling as your primary dx.