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Thread: Incident To and Nurse Visits

  1. #1

    Default Incident To and Nurse Visits

    AAPC: Back to School
    Can some one please clarify for me what the CMS "Incident To" guidelines state about nurse visit? As a coder, I have always been under the impression that in order to code for the 99211 nurse visit code, you must follow the incident to rule which means that a physician must be on site and present for advice before 99211 nurse visit code can be used. Is my thinking correct here? Can anyone provide me a link to the incident to guidleines that point this out?

    Here is the situation....One of my clinics is staffed completly by RNs. The physician is not present at all. He is located in another building across campus. Since he is not technically onsite in the clinic-can they still use the nurse code (99211) or does onsite mean in the clinic?

    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  2. #2
    Join Date
    Apr 2007
    North Carolina


    Direct supervision is defined as presence in the office suite where the services are being rendered, at all times while the services are being rendered. In addition, the physician must be immediately available to assist if needed.

    Refer to Supervision bullet...


  3. #3


    Thank you for this. This helps me!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

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