99211-Nurse Visit?


Beechhurst, NY
Best answers
Hi All,
I have a Provider who will NOTdo the venipuncture on same day for ALL the visits but will asked the patient to come on the next for the collection. And he wants to bill the next day visit as 99211-25 plus 36415 as NURSE VISIT.

1.) Are we allowed to bill for this nurse visit? The provider confirmed to me that he is not seeing the patient..

2.) Can somebody help me if the CPT for nebulizer treatament is 94640? and what is the Jcode? -J7609? or J7610?

All of these are Clinic Settings..

Thanks a lot!!
Per our MAC, Trailblazer, when a visit is exclusively for the purpose of a venipuncture code 99211 should not be submitted. The 99211 is an incident to service and the provider must have seen the patient prior to a nurse visit for evaluation of a condition.
I agree under these circumstances I would not bill for the 99211, only the venipuncture should be billed.

The J-code would be dependant on the medication used in the treatment.
Can you use 25 modifier on nurse visits

If the nurse does a pro time that needs the doctor to interject changes to the patients medication as well as give an ordered injection do you use a 25 modifier on the 99211?