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RN Level 1 Visit

J

jenp2005

Networker
Messages
51
Location
Sheridan, WY
Question: Can you bill a 99211 in addition to an injection fee/drug??
Thanks,
 
mitchellde said:
No you cannot, you can bill the injection admin fee and the drug only for injections.
Click to expand...

Interesting as I do agree. But when my wife when for her Supartz series of injections the ortho doc billed out 99211-25 and got paid for each follow-up visit (4). Now I wasn't there but I do know that an E/M outside of injection was most likely NOT done. But BC/BS paid the 99211. I would have made an issue outside of the fact that my wife had to pay a co-pay on the injection 20610 anyway.
 
inj

20610 is not a normal injection code. This is a joint injection and would be something a physician would do, not a nurse. Since the physician is doing this it is possible that an E&M would be billed with a mod 25 if appropriate.

As for regular injections (vaccines etc) the pediatrician I take my kids to bills the 99211 instead of the admin fee. They get paid but it is not correct coding. The most appropriate code would be the admin fee for the injection and not a 99211.

Thanks,
Stacy
 
Just to add a little twist to this conversation. 99211 and "incident to" have been on the OIG hit list for ages. I'd be really careful about making sure an E/M service actually took place, and there was physician supervision before coding 99211.
 
99211

jenp2005 said:
Question: Can you bill a 99211 in addition to an injection fee/drug??
Thanks,
Click to expand...

Typically no. If the nurse were to do something over and beyond the reason for the injection then you could charge. But to just charge the 99211 for the time to give the injection you can not charge as you would get that reimbursement in the administration code.

Hope this is helpful!
 
96372 99211 20090101 * 0
CCI edit bundles injection code 96372 and 99211 with a "0" indicator, which means the two can never be billed together, even with a modifier.
The injection code and drug should be charged without the 99211.
 
I have a question? I have some visits where the Dr seen the patient for a 99211 and thought it necessary for them to do a nebulizer as well. We attached the denial and sent notes and claim to a special unit and they still denied the claim for the NCCI edits. I also have one where the patient was seen by the Dr. for a rash and had immunizations on the same day with the 99211 and a 25 modifier. This was denied as well, even though the diagnosis is obviously a separately identifiable service.
Please let me know if these scenarios still apply to the NCCI edit or are these ligament appeals. :confused:
 
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