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Thread: Can you bill a 99211 with a UA?

  1. #11


    AAPC: Back to School
    You cannot bill a 99211 unless there is some sort of E/M done even if it's doing the vitals and a history by the nurse. I agree the doc has to give a dx a nurse is not able to do that. Theres a really good article below that really helps

  2. #12
    Join Date
    Apr 2007
    Columbia, MO


    Here is something to think about. I had a class last week and this was a scenario brought to class. The nurse evaluated the patient with symptoms and discussed the patient with the doctor much the same issue as brought up in an earlier post here. This is an established patient but the physican does not see the patient on this encounter. The physician tells the nurse what to do and what to communicate to the patient. Well to make a long story short the nurse "missed" something in her "evalustion" so therefore the physician did not get all the information, the patient then became very ill a few days later and now is in intensive care. This is a real scenario. If the physician has not evaluated the patient in a previous visit for the same thing then how is the malpractice insurance going to view this. Perhaps this should be one of the first places to check to verify that this can be done. I'm just sayin.

    Debra A. Mitchell, MSPH, CPC-H

  3. #13
    Join Date
    Apr 2007
    Woodbridge, VA


    One document I keep handy is "Documentation Requirements for CPT 99211" which can be found on www.trailblazerhealth.com. We are a large urology practice and come across this scenario all the time. If the patient only drops off a urine specimen, only the u/a is billed. If, however, there is face-to-face encounter with the patient with either the physician or ancillary staff, a 99211 can be billed (without modifier -25 which is the case for the majority of the insurances we deal with). Hope this helps.

    Zaida Aquino, CPC
    Northern Virginia Urology
    Last edited by zaidaaquino; 06-15-2010 at 10:43 AM.

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