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Thread: 99211 Prof Charge in OP Hospical Clinic

  1. #1

    Default 99211 Prof Charge in OP Hospical Clinic

    AAPC: Back to School
    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
    Join Date
    Apr 2007
    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
    Join Date
    Apr 2007
    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
    Join Date
    Apr 2007
    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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