Wiki Med p/u

[ALALA]

need some info on how to bill (if you even can) for med/rx pick up if/when the MD is out of the office. My MD is being advised at conferences and seminars that it's ok to bill 99211, but I'm leary of this as s/he isn't in the office or available at the time. any suggestions or input is greatly appreciated.

TYIA,
Angie

 

[ARCPC9491]

To me, simply picking up a rx and billing a 99211 is inappropriate.

Though 99211 is a "nurse visit" remember it is still an evaluation and management service - from what you described, they are not doing this

 

[dmaec]

I agree with ARCPC9491 and go further to say --- no way is picking up meds (most likely at the front reception desk) a billable service! ... I've often had to pick up meds/prescriptions, etc for myself, family members even other patients when we did transportation. There is "no visit" during this, you don't see anyone except the front desk people, no nurse, no doc...
unless they do it differently where you're at. Not to mention, if picking up meds, what meds are they picking up? FREE samples?
{that's my opinion on the posted matter}

 

[ALALA]

thank you all for the replies. My biggest concern is that the MD isn't readily available or on the premises; just the RN. Although we do employ a PA. If the PA is available and on sight, but the RN is the one seeing the patient to give the RX is this an allowable scenario for the 99211?

 

[FTessaBartels]

Actually evaluating & managing

If the PA or RN is actually seeing the patient, and providing the script, then it looks like a 99211 visit to me.

F Tessa Bartels, CPC, CPC-E/M

 

[zaidaaquino]

The following information is found on www.trailblazerhealth.com under Documentation Requirements for CPT 99211:
"99211 describes a service that is a face-to-face encounter with a patient consisting of elements of both evaluation and management[...]Among other things, code 99211 should not be used to bill Medicare solely for the writing of prescriptions (new or refill) when no other E/M is necessary or performed." It also states "a physician visit is not necessary to routinely provide stable patients with an ongoing medication supply. Therefore, the documentation for code 99211 or any other E/M code in this circumstance must demostrate a need for clinical evaluation and management." Based on that information, our practice does not bill 99211 just to pick up a prescription.

Zaida, CPC