pt/inr and 99211

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If a patient presents to the office for routine INR, we would not bill for a 99211. If the patient presents to the office for routine INR but says he's having a problem with the meds and not feeling well, at that time is it appropriate to bill 99211 if the nurse speaks with the doctor and the doctor needs to change meds etc.?


True Blue
Columbia, MO
Best answers
if the patient presents for a scheduled visit, then the nurse may tend to that patient and bill in this case a 36415, however if the patent expresses symptoms or complaints, then this is not scheduled and does not followed a prescribed plan of care and cannot be attended to by the nurse only. The provider will need to examine the patient and document the encounter. It is out of the scope of practice and responsiblities for an RN to examine and treat the patient without the physician having first seen the patient and written the plan of care for a followup encounter.