Wiki 99211 - I work for a pain management

[amieelyn2001]

I work for a pain management group that dispenses DME in our clinic. Often times patients will return to the clinic to pick up their DME equipment at a seperate visit. I have been asked whether a 99211 can be billed for this visit. I said no because there was no medical necessity for the visit and the education and fitting of the DME is included with that charge. Is this the correct response?

 

[Angela Schwarzkopf]

I would say you are absolutely correct in your response.

99211 is a greatly abused code; picking up DME is like picking up a repeat Rx - there is no evaluation AND management done for the patient by the nurse.

Just my $.02

Angela

 

[khawman]

Payers are watching 99211 due to fraud and abuse. 99211 is an eval. and management code. Picking up equipment is not a billable service - Do not code or bill for that service.