Wiki CPT 96372 - Billing Guidelines

[seniar]

When billing 96372 - the CPT states to only bill with "direct physician supervision", which I believe is defined as a physician has to be in the building in order to bill this code.

My questions is:

When we bill this code for depo-provera injections, we have the medical assistant give the injection to the patient, work up the chart, and send the chart to the physician that was in the office at that time for signature and supervision notes.
The physicians in our office are not wanting to sign off on patient charts that are not theirs, so they want us to send it to the patients physician for signature - not the physician that was in the office at the time of the injection - and they are saying that is okay becuase they all bill under the same tax-id.

Can anyone give their opinion on this? We dont want to get into a scenario where we cant prove which physician was actually present and why the physician that was no where near the patient at the time signed off on the chart.

Thank you!

 

[aaron.lucas]

from what I understand about services by med. assistants, PAs, etc. and what CPT says, if the injection is given by an assistant without a doctor in the room, I think you're supposed to bill 99211. as far as signing off I dont think someone who wasn't in the office at the time can sign anything because by signing it they are saying they approved what was happening and were available for help if needed, which wouldnt really be possible if they're not there. that's my understanding of it at least. anybody else have any thoughts?

 

[mitchellde]

You cannot use a 99211 if there is no physician on site. You must bill under the supervising provider, there needs to be an order in the chart from a previous encounter to show the patient is to return for this injection. We then have the person giving the injection document... "Per the physicin order of **/**/***, the patient presents today for their injection of xxxxx. Then we have had no pro lens having the aupervising provider sign off on the note.

 

[LaVoncye]

99211

99211 is a office visit , my understanding is if the reason for the visit is only for the sole purpose of the injection then that is all that is billed. the injection and the J code for the Depo. The physicians are in the same practice and they do bill as a group however, it should be signed of by the supervising physician at the time services were rendered. Whats happens if something comes up with the billing where services are being billed for two different patients, two different locations but under the same Dr. how is that possible.If /i was you I would be careful as billers take the fall for what ever they send out to the insurance company.

 

[thefosterfarm]

There is a good, short Depo Provera Flow sheet at http://www.aafp.org/fpm/2000/0700/fpm20000700p39-rt1.pdf. It could be used for a standing order so that a signature was not necessary each time. We have developed our own, and it has much more information on it. It would be a good idea for your physician to develop an office policy on Depo Provera injections also (specifically "when does the patient need to be seen by the physician", so they don't get caught in a loop of just getting their injections and never getting a pap smear/mammogram/health maintenance, etc).