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PPD order

  1. #1
    Question PPD order
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    I hope someone can help me out. If a patient needs a PPD for a requirement from their employer, is it necessary for the provider to see them so they can order the PPD and bill a 9911 or 99212? I have a provider who feels it is medically necessary to see the patient to order to PPD. The nurse can not give the PPD unless there is an order in the chart and the provider wont put an order in unless they see the patient.

    I hope this makes sense....
    Thank you,

    Abby Ronco-Hopkins, CPC, CPMA
    Family Practice Center, PC
    Medical Auditor

  2. #2
    As I understand it, an order is a payer requirement to ensure that services provided to a patient are a part of a physician's plan of care for purposes of benefits and coverage. In a case where the test is a requirement for employment, the service is going to be paid for out of pocket by the employer or employee and not going to be billed to an insurance plan, so I don't believe there is a requirement that it be ordered by a physician. However, you may wish to check your local or state regulations to see if there is any other restrictions on providing the test in the absence of a physician order or oversight.
    Thomas Field, CPC, CEMC

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