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99211 for self injection training

  1. Default 99211 for self injection training
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    I am looking for examples of the documentation needed for a 99211 billed by a nurse for self injection training. Where would I go to find documentation examples and guidelines for self injection training by a nurse billing a 99211?

  2. #2
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    Columbia, MO
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    I would look at 98960 instead.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
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    So it appears that 98960 is no longer covered by Medicare. You didn't specify who the insurance carrier is, which is fine. However, in the event the patient has Medicare (or to potentially avoid future denials with carriers following Medicare guidelines on 98960), I found the following from AARC:
    "Self-management education and training services are not separately billable codes under Medicare and are not paid by Medicare when submitted for any outpatient bill type (e.g., hospital outpatient, physician office). If the service is covered, payment for it would be bundled into the payment for other services for which the patient is being treated. This would be true in the inpatient setting as well where services are paid under the assigned DRG. However, certain private plans may not necessarily follow Medicare with respect to this issue and may cover these services."

    There is an article (from 2000 though) by AAFP which covers 99211 pretty well.
    "When you have exhausted all possibilities, remember this: You haven't!"
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