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Nurse visits

  1. Question Nurse visits
    Medical Coding Books
    We have in our office 2 RN's that do nurse visits occasionally. Since they aren't credentialed like physicians are, how do we bill for a nurse visit? I know we can use 99211, but do we bill it under the physician's name that the RN works under? I was under the impression that we can't bill nurse visits under the physician name or am I mistaken? I have read the CPT guidlines for it, but it is vague.

    Thanks for any input. dmiller

  2. #2
    Columbia, MO
    What types of things are you referring to as a "nurse visit". The only visits that can be billed for in a physician office setting are visits that are provider prescribed. The 99211 is a physician level encounter that is the level a provider may bill if a nurse or other ancillary person is the one with the patient carrying out a physician order from a previous encounter as long as the provider is onsite while the patient is being seen. In a physician office setting a Nurse cannot create their own encounter with a patient, it can only be followup to a physician order. You bill using the provider NPI and signature but that provider must be physicially on site while the patient is being seen.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    There are rules for billing the visits for NPs and PAs.

    However, If the services are performed by the nurse or MA, then the E/M 99211 code should be used, but these services would include suture removal, dressing changes, or wound check and billed under the physician's NPI. The physician must be on site when these services are done.


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