Hello!
I work in an ambulatory infusion suite that is run by a specialty pharmacy, which means that we do not have a supervising doctor on-site, we take prescriptions from ordering providers and our registered nurses perform the infusions for the patients. Usually I would bill a code like 96365 for IV Infusion therapy, which includes the nursing assessment with the supplies and length of time in the code. However, we had a situation recently where the RN performed her assessment and evaluation with the patient, created a treatment note, and then the patient had a situation where she could not get the drug so she had to reschedule the appointment. The patient has Medicare primary insurance.
In this case, given that the nurse had already performed a medical assessment, would I be able to bill 99211 for the evaluation even though she never received her drug? Can I bill Medicare for it, even though we do not have a doctor on-site? Or am I not able to bill for nursing services if the patient did not receive the drug on this day, and if there was no doctor in the building?
I appreciate the help!
I work in an ambulatory infusion suite that is run by a specialty pharmacy, which means that we do not have a supervising doctor on-site, we take prescriptions from ordering providers and our registered nurses perform the infusions for the patients. Usually I would bill a code like 96365 for IV Infusion therapy, which includes the nursing assessment with the supplies and length of time in the code. However, we had a situation recently where the RN performed her assessment and evaluation with the patient, created a treatment note, and then the patient had a situation where she could not get the drug so she had to reschedule the appointment. The patient has Medicare primary insurance.
In this case, given that the nurse had already performed a medical assessment, would I be able to bill 99211 for the evaluation even though she never received her drug? Can I bill Medicare for it, even though we do not have a doctor on-site? Or am I not able to bill for nursing services if the patient did not receive the drug on this day, and if there was no doctor in the building?
I appreciate the help!