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99211-dietician

  1. Default 99211-dietician
    Medical Coding Books
    I work in an hospital outpatient department, one of the nurses asked if a dietician visit would be classified as a 99211 when called in on the same day the patient is receiving treatment. I am thinking it would be, however I know she spends more than 5 minutes with them. I would appreciate any guidance.

  2. #2
    Location
    Louisville, KY
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    What service is the dietician furnishing?

  3. #3
    Location
    Columbia, MO
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    If you are billing for the facility then a visit in each department may be billed so you may have multiple visit levels just use the 27 modifier on the second and subsequent and a G0 condition code. As far as can this be a 99211 that depends on how your E&M assessments are evaluated. It can be whatever level your facility values it to be, a 99211, 99212, etc. there needs to be some way to assess this type of encounter in your facility.

    Debra A. Mitchell, MSPH, CPC-H

  4. Default
    the dietician discusses their eating habits/ability.. if she finds pt is unable to eat, she will provide them nutritional supplements such as ensure.

  5. #5
    Location
    Columbia, MO
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    In the facility I worked with we had any social work or dietician discussion rated as simple, 99211, moderate, 99212, and extensive was 99213. We then had our criteria for what was involved with each level, remeber time is not a factor in the facility. It is what resources were consumed. For the typw of discussion you are talking about it could go up to a 99212. You just have to remember that facility billing is very different from physician and the criteria for E&M is not even remotely similar.

    Debra A. Mitchell, MSPH, CPC-H

  6. Default
    Okay, in order to be in compliance...do you have any recommendations on what would be the best way to make sure there is documentation to cover her visit with the patient. Currently the nurses are only documenting that they had her come. The dietician doesn't document in our paper charts. Should we have her start doing so?

  7. #7
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    Louisville, KY
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    Would the 97802 series be appropriate, if you're basing coding decisions on time spent with the patient?

  8. Default
    That would make sense..however, shouldn't the dietician be charging that? Our nurses don't provide the service, they just call her in. Our nurses evaluate the patient's needs, then if needed or requested they call in the dietician, social worker, and/or the counselor. None of which enter charges, so they are basically free services. Not real sure if that is the way it is suppose to be. So, should we be charging for these?

  9. #9
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    Columbia, MO
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    Quote Originally Posted by rross View Post
    Okay, in order to be in compliance...do you have any recommendations on what would be the best way to make sure there is documentation to cover her visit with the patient. Currently the nurses are only documenting that they had her come. The dietician doesn't document in our paper charts. Should we have her start doing so?
    Yes absolutely! And your outpatient assessment tool or whatever you call it should have a way of assessing the documentation for a visit level.

    Debra A. Mitchell, MSPH, CPC-H

  10. #10
    Location
    Columbia, MO
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    I suppose you could use the 97802 codes but you should check to see the revenue center relationship with those codes, they may not work in in a 510 revenue center. My recollection is that they did not which is why we used a visit level when performed in our 510 clinic setting.

    Debra A. Mitchell, MSPH, CPC-H

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