Wiki billing ins for s/r when doc not in office

[debneas]

Can we bill the insurance company if a patient comes in for s/r with a nurse visit when the provider is not here?

My feeling is if bx done yes with a 99211, but an excision no.

 

[teresabug]

you cannot bill for suture removal if your provider performed the original procedure. He got paid for all post op care in the procedure code he billed. Only if another provider (different group NPI/tax ID.... like pt seen at ER by on call doc) placed stitches can your provider bill to remove them. You would bill 99211 only if an RN removed the sutures in this scenario (and this removal must be documented)
There are 2 actual "suture removal" codes" one for the anal area and for those done under anesthesia.

 

[mitchellde]

you cannot bill for suture removal if your provider performed the original procedure. He got paid for all post op care in the procedure code he billed. Only if another provider (different group NPI/tax ID.... like pt seen at ER by on call doc) placed stitches can your provider bill to remove them. You would bill 99211 only if an RN removed the sutures in this scenario (and this removal must be documented)
There are 2 actual "suture removal" codes" one for the anal area and for those done under anesthesia.

If the surgery was performed by a different provider the nurse could not remove the sutures at all. A nurse can only follow the orders of the provider they are employed by. In addition you cannot bill suture removal for a procedure that has a global by using a 99211. A nurse cannot be the only medical person in the office if a patient is being attended to. Billing a 99211 for a nurse to see the patient must meet the incident to parameters.