Wiki RN working under MD standing orders

[akalyssarae]

I have a question of "other qualified health care professionals"

In our clinic we have a MD who has standing orders for RN's who see patients. My question is, can those visits only bill as 99211 because they saw the RN even if the visit audits to a higher level because the visit fell within those standing orders?

Any insight will be VERY appreciated.
Thank you!

 

[thomas7331]

Generally speaking, yes, that's correct, an RN visit cannot be billed at a higher level than 99211 because all higher levels all require a face-to-face visit with the physician or NPP.

Regarding 'standing orders' - I'm not sure what orders exactly this physician is using, but in my experience, standing orders are generic orders that are not specific to an individualized plan of care. I would just caution that standing orders alone may not meet the 'incident to' requirements necessary to be able to bill 99211, which include the requirement that the physician has personally evaluated that patient for the particular problem being treated and that the nurse visit is a component of the plan of care established by the provider at a previous visit.