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E/m 99211

Thumper72

Contributor
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20
Location
Yakima
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0
Inquiring for a co-worker...I am wondering if a phlebotomist that works for the local Health Department can charge a 99211 if they are spending time counseling the patient prior to doing blood draws for HIV or Hep C, etc. Is there a specific license that can bill this code?

Thanks for any help!!
 

LindaEV

Expert
Local Chapter Officer
Messages
437
Location
Kansas City, MO
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0
Probably not.

What would a phlebotomist be "counseling" on? What exactly are they "evaluating and managing"? Is there a physician on site who is contracted with the payers?
 

Thumper72

Contributor
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20
Location
Yakima
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There is not an MD on site, but he does over see what they do. The phlebotomist counsels on Risks, Pre counseling, Education, protecting themselves, & obtains a Social Hx. If the 99211 can not be billed, is there a code that should be used?
 

Thumper72

Contributor
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20
Location
Yakima
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0
Still looking for an answer

I'm still in need of some advice on this situation. If anyone can provide some thoughts that would be great. Thanks.
 

cheermom68

Expert
Messages
451
Location
Evansville Indiana
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0
99211

Irregardless of the whether a phlebotomist can charge 99211 and what they are documenting, if there is no physician on site, a 99211 cannot be charged because it does not meet incident to guidelines and a phlebotomist does not have an NPI to bill under.
LeeAnn
 

MnTwins29

True Blue
Local Chapter Officer
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1,188
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New Windsor, New York
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for 99211...

Irregardless of the whether a phlebotomist can charge 99211 and what they are documenting, if there is no physician on site, a 99211 cannot be charged because it does not meet incident to guidelines and a phlebotomist does not have an NPI to bill under.
LeeAnn
The physician does not have to be present to bill the 99211. However, given some of the other information in the original question, such as the various conditions for which the phlebotomist is providing counseling, I question whether this is a "minimal" problem and only 5 minutes or so is being spent with these patients. I have reservations about using this code for these encounters.
 

cheermom68

Expert
Messages
451
Location
Evansville Indiana
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0
99211

A physician does have to be present in the office suite to bill "incident to" and this is the only way that a 99211 can be billed for this encounter. Phlebotomists are not issued NPI's to bill under. Coumadin clinics have gotten caught on this one, billing a 99211 when no physician was on site. If a nurse, MA, phlebotomist etc is performing a service (99211, etc) using a physician or NPP NPI number the physician must be onsite.

LeeAnn
 
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