I have been billing (through a billing company) for a county health department for a while now and I just found out that the visits that I am sending out are nurse visits (RN) however they are being sent under the health officer with a regular E/m code not the 99211. Its my understanding that if the physician or np did not see the pt we can not bill out a nurse only e/m visit with anything other then 99211. Im also finding out a qhp isnt even in the building. They say they have a health officer and that is all they need. So that being said, im not familiar with the health department rules and regulations so is there an exception to these rules Im not familiar with. I asked the health dept and All I get is. We can do it this way and that they have done it this way for 18 yrs and they follow their protocols. please please if someone can help me. Ive looked everywhere and cant find any documentation.