Wiki Education and Training by a Nurse

[panetta76]

The oncology department is trying to help patients diagnosed with cancer by providing education and training by a nurse. We were looking at code 98960 but it isn't covered by BCBS or Medicare. We looked at code 99415, but we aren't sure the patient will feel up to staying after the doctors visit. Does anyone have any suggestions?

 

[OpenClaims]

Hello, my first though is if this was done in a hospital (outpt) or office setting. Then, is the nurse an RN, trained and certified, in this area to bill for this (per insurance). If an RN is educating and the patient does not see a MD or NPP it would be hard to bill for this service. 98960 states in the description that a NPP would perform these services, an RN would not fall in that category and 99415 is an add-on code and would need a primary code in order to bill for it. Also, any of the E/M visits would not be billable in this case because a nurse does not have the ability to diagnosis and treat. So i may need some more information to help you a little better. Or look into some of the Category III codes in the back of your book and see if there is a code that specifies this service better.