Coding question-billing for the infusion

abill_423

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I am relatively new to coding and have a question that I hope someone can help me with. I am posting charges for our CKD clinic. We give Procrit injections and IV infusions of Venofer at this location. We normally have a physician present when these things are given. Last month, we had 2 days where the physician called out sick. When billing Procrit injections, I normally use codes 90772 (injection) and J0885 (Procrit). When billing for the infusion, I use codes 90765 (intravenous infusion) and J1756 (Venofer). Since the physician was not physically present when the Procrit and Venofer were given, I can't bill the 90772 and 90765 codes. I am confused about when I can use the 99211 code. The nurse has to check and moniter blood pressure when Procrit and Venofer are given. Can I bill a nurse visit 99211 plus the medicine (J0885 or J1756)? I have had some people tell me that you can bill a nurse visit if the physician is not in the office but is available by phone. Or should I only bill for the medicine that was given?

Thanks for any help in clearing this up for me.
 

safnlp

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why cant you bill the 90772 and 90765 the dr does not have to be there to bill these codes along with the medicine
 
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johnithomas

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Ok I misunderstood .......


Per CPT guidelines you ARE to report CPT 99211 if you do not have the Physician on site.

CPT 90772, and 90765 state that services require direct Physician supervision ( for patient assessment ) if you look at 90772 it states not to report for injections given without Physician supervision to use 99211.
 

safnlp

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90765 is for the infusoin so if you are doing a infusion you should always report that code as someone has to monitor the pt for the infusion
 
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