99211 with INR

desireeI@yahoo.com

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Local Chapter Officer
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15
Location
Lewiston, ID
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I am struggling with this I have started coding for outpatient hospital family practice and we are doing INR's and I am being told to add a 99211 with the 36416 and 85610 if meds are changed. I have done research on this and I find this to be "incident-to" which when I look up the guidelines for "incident-to" it say • The physician/NPP that provides the oversight may not bill for the services of hospital employees. Only the hospital may bill for the services of hospital employees. So to me we can not bill the 99211 due to the hospital pays the ancillary staff not the physician. But when I talk to other codes they say according to the AMA CPT 2017 Professional book when you look up 99211 it says "that may not require the presence of a physician or other qualified health care professional. I am also being told that 99211 does not require face-to face? If any one can please help that would be great. Thank you very much.

https://med.noridianmedicare.com/we...-to-clarification-for-opps-and-cah-outpatient
 

nanmh971

New
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1
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Portland, OR
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I am struggling with this I have started coding for outpatient hospital family practice and we are doing INR's and I am being told to add a 99211 with the 36416 and 85610 if meds are changed. I have done research on this and I find this to be "incident-to" which when I look up the guidelines for "incident-to" it say • The physician/NPP that provides the oversight may not bill for the services of hospital employees. Only the hospital may bill for the services of hospital employees. So to me we can not bill the 99211 due to the hospital pays the ancillary staff not the physician. But when I talk to other codes they say according to the AMA CPT 2017 Professional book when you look up 99211 it says "that may not require the presence of a physician or other qualified health care professional. I am also being told that 99211 does not require face-to face? If any one can please help that would be great. Thank you very much.

https://med.noridianmedicare.com/we...-to-clarification-for-opps-and-cah-outpatient
Hello! I know this was a while ago, just starting my training for CPC and looking thru these forums. Wondering what the outcome was here? Did you ever get a definitive answer somewhere else? Thanks!
 

msksmith

Contributor
Messages
24
Location
Rosharon, Texas
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I am struggling with this I have started coding for outpatient hospital family practice and we are doing INR's and I am being told to add a 99211 with the 36416 and 85610 if meds are changed. I have done research on this and I find this to be "incident-to" which when I look up the guidelines for "incident-to" it say • The physician/NPP that provides the oversight may not bill for the services of hospital employees. Only the hospital may bill for the services of hospital employees. So to me we can not bill the 99211 due to the hospital pays the ancillary staff not the physician. But when I talk to other codes they say according to the AMA CPT 2017 Professional book when you look up 99211 it says "that may not require the presence of a physician or other qualified health care professional. I am also being told that 99211 does not require face-to face? If any one can please help that would be great. Thank you very much.

https://med.noridianmedicare.com/we...-to-clarification-for-opps-and-cah-outpatient
Same here....Did you find the answer?
 
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