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RN charging 99211

  1. #1
    Default RN charging 99211
    Medical Coding Books
    Pt. present to his oncology/hematology outpatient infusion clinic for his scheduled chemo infusion appt. or an ordered lab draw. His nurse decides to change the bandage at his port site. Can she charge a 99211 E/M level for changing the bandage in addition to the other services provided? What if he presents for no other reason than to have the bandage changed? If so, what documentation is required, and is an order from the MD required?

  2. #2
    Columbia, MO
    A nurse cannot "decide" to charge a 99211. This is a physician level and it is the level a physician can charge when a qualified staff memeber is the one face to face with the patient completing a physician order. So yes the physician must have a plan of care in the chart from a previous encounter with an order for the patient to return for a service. You may not charge a level on the same day as chemo and you may not charge a 99211 for a blood draw encounter, even if the bandage is changed. If the patient comes in just to have the site checked and the bandage changed, as long as there is an order in the chart for this and the physician is on site in the office suite area then you may use a 99211.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Thank you Debra Mitchell for confirmation. That is how I understand it, just wanted an objective opinion!

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