MA visit only

mosmith

Networker
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Loganville, GA
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Hello everyone

If a new patient walks in to have a urine pregnancy test, blood drawn, or to get an immunization and only see the MA is it okay just to bill the procedure code only and no E/M?
 

mitchellde

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Columbia, MO
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The MA is not a qualified healthcare provider to see a patient and determine the appropriate procedure or care. The physician must first see the patient and order that those services be performed. These cannot be billed as incident to since the provider has not ever evaluated the patient for this issue.
 
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I agree. A patient can't just walk in and ask for a vaccine. A provider would have to evaluate and determine if the vaccine was appropriate. Vaccines are tracked closely; each has its own individual identifying number/ID/etc (like an SSN) and that's charted all over the place. Blood draws fall along the same line. A provider would have to see the patient and have valid, medically necessary reasons for needing a blood draw.

As far as a urine pregnancy test, I'm not sure why someone wouldn't just go buy a test at a store. There are also "free clinics" and similar type facilities (which will go unnamed) that a patient could visit. You should probably steer clear of referring them to these facilities because it could be construed as a "referral."
 

thomas7331

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The other posts are correct that an MA cannot perform services that are not ordered by a physician or NPP, with the exception of certain services that can be performed with 'standing orders' (I believe this is how pharmacies are able to provide some vaccines such as flu shots without having the patient be evaluated by a physician first).

But to your original question, the answer would be yes, it's OK and appropriate to bill just the services performed without an E&M. As long as the services are appropriately ordered and supervised, you can bill just those services. The orders may have been made by the physician without a face to face encounter, or at an E&M encounter on a prior date.
 
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