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Thread: 99211 - I work for a pain management

  1. #1
    Join Date
    Apr 2007
    Lafayette, LA

    Default 99211 - I work for a pain management

    AAPC: Back to School
    I work for a pain management group that dispenses DME in our clinic. Often times patients will return to the clinic to pick up their DME equipment at a seperate visit. I have been asked whether a 99211 can be billed for this visit. I said no because there was no medical necessity for the visit and the education and fitting of the DME is included with that charge. Is this the correct response?
    Last edited by ank3t; 10-20-2016 at 04:28 AM.
    Amy D. Broussard

  2. #2
    Join Date
    Apr 2007
    Portsmouth Virginia


    I would say you are absolutely correct in your response.

    99211 is a greatly abused code; picking up DME is like picking up a repeat Rx - there is no evaluation AND management done for the patient by the nurse.

    Just my $.02 :-)


  3. #3
    Join Date
    Apr 2007


    Payers are watching 99211 due to fraud and abuse. 99211 is an eval. and management code. Picking up equipment is not a billable service - Do not code or bill for that service.

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