Billing a 99211 with a 36415

beckyruiz

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Is it okay to bill for a 99211 with a 36415 (lab draw) if patient is only in for a lab draw. Patient was seen by provider the day before and is in today for a lab draw only. Can a 99211 also be billed?

Thank you.
 

efrohna

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If the patient comes in just for a lab draw & sees only a lab technician, or phlebotomist you should not bill a 99211. Only the labs & venipuncture should be billed alone.

However, a 99211 may be reported with certain lab visits/checks IF the visit is medically necessary and medical decision making is involved and the documentation supports the visit.

99211 is an incident to service indicating that the visit is based on an established physician treatment plan.

Hope this helps.
E. Frohna:)
 

carafry

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99213 & 36415

If it is only a blood draw, you cannot bill the 99211 in addition. Professional services provided by the clinical staff are figured into the draw fee. If something medically necessary were done in addition to the blood draw (such as a blood pressure check or weight monitoring), a separate visit code would be justified.
 

member7

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I agree with carafry and relong. 99211 is a controversial E/M code that is frequently subjected to external monitoring. Don't leave yourself open to an audit over 99211.
 
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