99211 or 98960 for diabetes education by RN

cbeste

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Albuquerque
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An RN at our practice does diabetes education sessions with patients but she is not a certified diabetes educator. Can we bill a 98960 for these visits, or are only diabetes educators permitted to bill that code? If she is not permitted to bill a 98960, can we bill a 99211 for the visit instead?
Thanks in advance for any help with this!
 

cbeste

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Thank you for the response. Are RNs required to be certified diabetes educators in order to use 98960 for diabetes education?
 

rgunwall

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Dickinson, ND
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We use the G0108 now since we are accredited and have a certified diabetic educator but before that we only used the 99211.
 

shsteen

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Can we bill for diabetes education only if there was not an office visit with the dr correct? Also, can we bill additionally for insulin pump downloads or glucose meters?
 

rgunwall

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Last edited:

tpgrice

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Ok... Let me see if i have this straight. I am trying to file BCBS of SC with a 98961 for group diabetic education. It denies as not separately payable. So instead, use a 99211? Is that correct? What kind of documentation would be required? I am aware that the code doesn't have specific requirements but i am sure that there needs to be some sort of note in the chart. i am new to all of these group counseling and education codes.
 
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