99211

kmaher

Networker
Messages
44
Location
Bay City
Best answers
0
Can you bill an E/M of 99211 when a pt comes back to have a TB test read? I thought I read some where that you could, but I can't seem to find where I read that at. Any thoughts?

Thank you to those who respond!!!!
 
Last edited:

ARCPC9491

True Blue
Messages
700
Best answers
0
No, it is not proper to bill a 99211. The reading is included in the TB code.

Now, if it's positive - that obviously requires an E/M service by the provider.
 

RebeccaWoodward*

True Blue
Messages
3,126
Location
North Carolina
Best answers
0
Ok...let me throw a curve ball.

In the back of your CPT book, it provides clinical examples of E/M codes.

99211=Office visit for a 42 year old, established patient, to read tuberculin test results.

What's your interpretation of this? I'm signed up on other coding forums and this question is asked often and this except is often referenced.
 

ARCPC9491

True Blue
Messages
700
Best answers
0
my Expert edition doesn't have examples, let me pull the Professional edition.... be right back :)
 

ARCPC9491

True Blue
Messages
700
Best answers
0
I read it but... I just don't agree.

Here's a few references I have found:

Trailblazer (Medicare) - specifically states it is included.
http://www.trailblazerhealth.com/Tools/FAQs.aspx?ID=5442

These people say the same too...
http://www.physicianspractice.com/index/fuseaction/qa.details/qaID/204.htm

Let me add:
If you spend significant time with a patient reviewing the results or providing instruction, it would be appropriate to report those activities using an E&M code; you would select the level of E&M codes based on the E&M coding requirements. (From the second link above)

Simply looking for 2 seconds and saying negative - doesn't support a 99211.

Also, keep in mind, some insurance plans will apply a copay to the 99211 because it's an evaluation and management service - whether it's MD or not -I would be pretty ticked if I got a bill for 20 bucks for 2 second service to tell me something I already knew, that it was negative.:)
 
Last edited:

RebeccaWoodward*

True Blue
Messages
3,126
Location
North Carolina
Best answers
0
Although we don't charge for the reading, it does create a margin of question. I do agree that it would create bad PR if the patient was charged for the reading and a copay was applied. I think it's safe to say that we all agree.
 

ARCPC9491

True Blue
Messages
700
Best answers
0
Yes I agree! I would love to hear from the practices that do charge for it, what their experiences are with the insurances and their patients.
 

Liliana07

New
Messages
1
Best answers
0
Hello, I was wondering if updated regarding this issue:
Can you bill an E/M of 99211 when a pt comes back to have a TB test read? I thought I read some where that you could, but I can't seem to find where I read that at. Any thoughts?
 

Pathos

True Blue
Messages
597
Location
Beaverton OR
Best answers
1
The TB read is bundled with the 86580 code. E/M are meant for problem focused visits, and a lab study read is not a problem, but just a screening.
 
Top