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nurse visits???

  1. Default nurse visits???
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    I work at an Urgent Care in a town that has a shortage of medical providers. Often people will call their PCP and they can't get in to see them for weeks and new patient appointments are an average of 3 months out. As a result we often get patients who come and check in and then once they are roomed they will tell the MA that they want to be seen for a chronic condition or something that is out of our range of care. We end up spending the time to call their clinic and intercede to try to get them in to see their PCP and then we check them out and don't bill for anything. This happens a lot and I am wondering if anyone has any opinions/suggestions as to whether we could bill a nurses visit for this or if I should just let it go?

  2. #2
    Columbia, MO
    If you are wanting to bill a 99211 for these the answer is no. They do not meet the criteria for a 99211 since the provider did not see them and order this visit as a followup. There really is no level of care than can be billed for this encounter. Perhaps the physician or NP should at least see the patient and give them a quick visit and then charge out a provider encounter.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    Agreed; there is no code for a nurses visit. Take vitals and have the provider "pop in" for at least a low level evaluation. I could see how this could result in, for lack of a better word, wasted time for your providers but at least then you could be billing for the service provided. Especially if it's happening often enough that it's becoming disruptive to your practice's schedule and staff.

    Another suggestion, maybe have a conversation with your front office staff to discuss some better ways to triage these calls (unless they are walk-ins, of course). That way, maybe these types of appointments don't get put onto the schedule at all. I've worked in a PCP office for 8 years, so I can understand how this can be frustrating for an urgent care staff. Hope this helps a bit.
    Last edited by jhendrix08; 10-16-2018 at 08:52 AM.

  4. Default
    Medical Billing
    Thanks, that's what I thought;(

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