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Wiki RN Level 1 Visit

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jenp2005

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Sheridan, WY
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Can you bill a RN Level 1 visit with a lab draw like a PT/INR and if so what critieria needs to be met?
 
There needs to be a separate and identifiable E/M service. So that means there needs to be medical necessity for a nursing visit beyond just getting their labs drawn. Perhaps the patient comes in with a concern about a skin lesion, and the nurse examines the area. There's an e/m service.
 
A nurse cannot examine a new problem for the patient and charge a level of care. A nurse (RN, LPN), may only follow the providers orders from a previous encounter and there must be a provider in the office at the time of the visit. You may not use a 99211 for a blood collection encounter, there are unique CPT code especially for this service.
 
Pt/inr

I agree that you can not bill a 99211 for blood collection. But I do believe it CAN BE appropriate to bill a 99211 and also collect blood for a PT/INR at the same time. It is quite common for offices to have PT clinics where nurses are following orders provided by and supervised by a physician. If documented well, you can definetly get paid for the work being done.
 
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