Wiki 99212 vs 99211 debate

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bill2doc

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Office debate - 99212 must be face-to-face with PHYSICIAN correct ? What would be the defination of " OR qualified health care professional" ???

Medical assistants believe they can charge a 99212 when they give an injection...
... ie 99212-25, 96372

I say you can only charge a 99211 for a medical asst doing the injections and you wont get paid for both the 99211 and the 96372....so just submit the 96372

Can anyone offer help. Thanks!
 
you cannot charge a visit level for giving an injection, and you cannot use above a 99211 for an MA encounter. They are not in the consideration of "other qualified health care professional"
 
Totally agree with the above! You'd be billing the admin fee not a 99211 if the MA is giving an injection.
 
Also agree...99211 can not be billed for an MA visit...the "visit" is included in the administration code (i.e. 90471, 96372, etc.) -- the visit is considered part of that charge.
 
99211 is a "nurse visit" and does not require the attendance of the physician
99212 is a physician service visit

If the patient is in the office for the purpose of getting an injection and does not see the physician 99212 is not a viable code for the service.

The injection code should be used without any E&M if the service is performed by a MA
 
99211 is NOT a nurse visit. It is a physician visit, that the physician is allowed to charge when qualified ancillary personnel are with the patient (while the physician is on site) carrying out orders from a previous visit and no other CPT code is available such as repeat BP checks. However a physician can bill a 99211 for a physician visit.
 
Thank you all very much! You helped clear that up. There is always a push back from what I think we can bill and what the MA's think we can bill. We also perform a PTNS procedure which is a needle in the leg that the patient comes in and gets for about 30 min.... I don't think you can charge a 99211-99214 unless the Dr speaks to the patient for the listed time. I think only the 64566 should be charged if the MA is hooking up the patient and getting them settled in for the service.

By the way, is there a list of procedures that MA's can and cannot carry out? I'm confused on exactly which procedure they are "allowed" to do and feel they might be doing things that they shouldn't be doing???? I don't think the doctor knows any better. Where can I go to research that ??

Thanks again!!
 
Also - what classes would you recommend for the MA's to get more background on e/m coding ???
 
MA's also state there are times with doc comes in during injections to go over test/labs....which I thought was considered part of initial visit but I could be wrong...
 
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