Wiki Can we bill for a 99213 and co-pay?


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I think I know the answer but would love if someone would confirm


Patient comes in office, sees the nurse for a testo injection and charges the pt an office visit and $30 co-pay

Week later pt comes in sees non credentialed office employee, gets shot and gets charged office visit and $30 co-pay

Can either of these scenarios warrant a 99213 charge and collection of $30 co-pay?

I thought it was face to face w/ physician only!

You absolutely cannot charge a 99213 for anything other than a physician or NPP. When the patient comes to the office for an injection of anykind you can bill the admin charge 96372 for therapeutic injections. You cannot charge an office visit. You cannot charge even a 99211 for an injection. The physician has already charge an office visit when the assessment was performed and the plan of care developed to include these injection, the nurses time and skill to administer this injection is part of the injection admin code. You must charge the admin and the J code for the drug and nothing else. If this drug is not covered for the dx you have then the payer will deny it. You cannot "hide" a coverage issue behind an office level.