Wiki 99211 with an Office Visit E/M

[Aotearoa16]

The patient was seen by the nurse for a PPD skin test placement and then by the doctor for a typical office visit. In the office visit the provider mentions that the patient received the skin test on that day and the documentation read was ordered. My understanding is that two E/Ms cannot be billed on the same date when under the same provider/specialty on the same date in the office setting. The nurses visit is being billed under the doctor. Can 99212 and 99211-25 with 86580 be billed?

How about when the nurse visit is directly related to the doctor visit? For example, a patient comes in for an ulcer and is seen by the nurse for wound assessment and treatment (compression) and also by the doctor for treatment goals and planning. 99213-25, 99211-25, and 29581-LT all on the same date.

Thanks!

 

[thomas7331]

The patient was seen by the nurse for a PPD skin test placement and then by the doctor for a typical office visit. In the office visit the provider mentions that the patient received the skin test on that day and the documentation read was ordered. My understanding is that two E/Ms cannot be billed on the same date when under the same provider/specialty on the same date in the office setting. The nurses visit is being billed under the doctor. Can 99212 and 99211-25 with 86580 be billed?

How about when the nurse visit is directly related to the doctor visit? For example, a patient comes in for an ulcer and is seen by the nurse for wound assessment and treatment (compression) and also by the doctor for treatment goals and planning. 99213-25, 99211-25, and 29581-LT all on the same date.

Thanks!

All nurse services are considered incidental to physician's service, whether related or not, so there is no way to bill a 99211 together with another E&M service on the same day in the same provider's office. You can only bill one single code to represent all of the E&M work on that date.

 

[Aotearoa16]

All nurse services are considered incidental to physician's service, whether related or not, so there is no way to bill a 99211 together with another E&M service on the same day in the same provider's office. You can only bill one single code to represent all of the E&M work on that date.

Thanks! That's what I thought so I've been adjusting 99211 when it comes across on the backend, but I've seen them billed together often enough that I started to second guess myself, oops XD

 

[ntmenendez@hotmail.com]

I realize this post was in 2023, however, I would like to know if you were able to bill 99213 with 86580 sameday? Or just the 99213?
Thank you