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99211 Prof Charge in OP Hospical Clinic

  1. Default 99211 Prof Charge in OP Hospical Clinic
    Medical Coding Books
    Consider this:

    A patient is seen in an outpatient hospital clinic for a weight check (or anything else that does not have its own CPT code). The weight check is performed by a Medical Assistant who is the employee of the hospital. The clinic is overseen by physicians who are in the employ of a group that is separate from the hospital.

    Question: Is the physician permitted to bill a 99211for the service that was rendered to the patient?

    Thanks for your input!

  2. #2
    Milwaukee WI
    Default No
    No service was provided by the physician or HIS staff (the MA is an employee of the facility, not the medical practice). So, no physician bill.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Seacoast- Dover New Hampshire
    What about the Internal Medicine MA doing 85610 and 36416? I though that if the note was written about the encounter and the Provider signed it, you could use 99211.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  4. #4
    Milwaukee WI
    Default No Significant Separately Identifiable E/M
    In order to code any E/M along with a procedure you must have documentation of a signifant separately reportable E/M. The scenario you describe has no such service ... NO physician bill.

    F Tessa Bartels, CPC, CEMC

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