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sheila trout, cpc

  1. Default sheila trout, cpc
    Medical Coding Books
    Recently we listened to Terry Fletcher on 2010 Gastroenterolgy Coding updates. In her discussion she talks about being able to bill for your Certified Medical Assistance to give injections and education on injections to Hep C patient and Humira injections. This is something we have never done. My understanding is that the MA giving the injection/education needs to document the visit just like the doctor would to include time spent. That visit would then be billed out as a 99211 under the supervising doctor in the clinic that day. if the patient came in with their own medication and the MA only gave the injection that would be non-billable but if there were questions to be answered or help in administrating the injection that would be billable. Is this correct? I want to make sure that all my ducks are in a row before proceeding with this. thank you for your help. sheila.trout@wwmedgroup.com

  2. #2
    Location
    Columbia, MO
    Posts
    12,843
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    a 99211 may be billed for a MA to perform a service ordered by the physician on a previous encounter for which no CPT code exisits. You may not bill a 99211 to give a planned injection. There is a CPT code for an injection administration and you do not have the criteria to bill a 99211 plus the admin code and you cannot use the 99211 instead of the injection admin when that is the service planned and performed.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default Sheila Trout, CPC
    ok, thanks for the info. Terry Fletcher cpc, ccs-p, ccs, cmscs, cmc, cemc, ccc, and medicare auditor states that we can, so now i am really confused. Can you tell me where you got your information so that I have a reference for it as well.

  4. Default Ma 99211
    Sheila, Where are you located? Noridian has specific information about when you can bill 99211. Google Noridian "incident to" clarification 99211. If your with Trailblazer or something else, I am not sure what their guidelines would be.
    Jennifer Crowell CPC, CCC, CEMC

    Quote Originally Posted by Sheila Trout View Post
    ok, thanks for the info. Terry Fletcher cpc, ccs-p, ccs, cmscs, cmc, cemc, ccc, and medicare auditor states that we can, so now i am really confused. Can you tell me where you got your information so that I have a reference for it as well.

  5. Default Sheila Trout CPC
    I am located in Washington State. Any help would be appreciated. This is quite a confusing issue

  6. #6
    Location
    Columbia, MO
    Posts
    12,843
    Default
    You can use a 99211 for activity ordered by a physician on a previous encounter and is being carried out by qualified ancillary personnel. However there is no justification for using a 99211 to give an injection when a code exisit for this purpose. Katheleen Mueller who was the compliance officer for CMS in 02 wrote a special report for Decision Health regarding the appropriate use of the 99211 this report was published Feb 11 of 02 and in this report she specifies that billing a 99211 for venipunctures or injection admin is inappropriate, even if the MA (or Nurse ) performs vital signs.

    Debra A. Mitchell, MSPH, CPC-H

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