if it is a visit for a blood collection only then you cannot use a 99211 you can use the CPT code for blood collection, taking vitals does not make it a 99211. The nurse is following physician orders from a previous encounter and is not doing anything beyond those orders, also vitals signs are an intergral component of every procedure we offer, as it is important to know so that the result of the lab can be thouroughly evaluated. There is no MDM component for a 99211 the nurse cannot independently evaluate a patient. the 99211 is a physician level of service allowed for the provider to charge when another qualified ancillary person is the one face to face with the patient carrying out orders from a previous encounter with the physician. If there is a separate CPT for this activity you cannot elect to use the 99211, if there is no CPT then the 99211 may be used. Such as there is no CPT code for the ear irrigation so when the patient returns to have their ears irrigated then it may be charged as a 99211.