Colliemom
Expert
When an APRN administers a PPD test, can they bill a 99211 in addition to the 86580?
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Wiki PPD test coding
- Thread starter Colliemom
- Start date
codingwithkelly
Contributor
No. There is no EM involved with administering the PPD. And, if there is no reaction, no 99211 can be billed for the read.
Peter Davidyock
Expert
86560 is for the administration of the test only. CMS has clarified this years ago. They understand that not everyone returns for the reading and as a result they removed the follow up portion of the package (to lower reimbursement) because they were continually paying for something that was not happening.
The nurse visit to read the test (whether it's positive or negative ) represents an expense to the practice and is thusly a billable service so long as no ther E/M or billable service is performed that day and incident to requirements (if required) have been met.
Here is a good article regarding the subject. It's an older article but nevertheless it outlines policies still in effect to this day:
http://medicalnewswire.com/artman/publish/article_26.shtml
The nurse visit to read the test (whether it's positive or negative ) represents an expense to the practice and is thusly a billable service so long as no ther E/M or billable service is performed that day and incident to requirements (if required) have been met.
Here is a good article regarding the subject. It's an older article but nevertheless it outlines policies still in effect to this day:
http://medicalnewswire.com/artman/publish/article_26.shtml
Last edited:
Colliemom
Expert
Thank you!