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Thread: billing 99211 for prescription pickup

  1. #1
    Join Date
    Apr 2007

    Default billing 99211 for prescription pickup

    AAPC: Back to School
    Can anyone suggest where I can find information on if I can bill a 99211 when a patient comes in only to pickup a RX?


  2. #2
    Join Date
    Apr 2007
    Bangor, Maine


    I don't know if this will help but I just posted this on another post in this forum.

    I was taught that when you charge a 99211, minimal visit, documentation of the actual evaluation and management for the patient has to be done, including History, exam and MDM, even though they will be minimal, as it is still an E&M service. There also has to be medical necessity proven in the documentation. When you code the 99211, the NIP# that you bill under, whether it is NP or Dr, that person has to be in the office suite. I was specifically taught that it can not be used for phone calls, blood draws, or injections or infusions of medications. Let's say that we have a patient who is on coumadin and comes in for an INR check and that's all, even if the last one was reviewed with them and it is decided whether or not it will be increased, decreased, or stay the same, that does not qualify in itself for the 99211 code to be charged. There has to be a Hx, Exam, MDM done. Hope this helps

  3. #3
    Join Date
    Apr 2007
    Mobile, Alabama


    Billing any level of E/M service for some patients means also collecting a co-pay. Frankly, if I had to fork out a $25 co-pay for picking up a prescription, I would be most unhappy !!!

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