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PPD Reading - went to another

  1. #1
    Location
    Overland Park, KS
    Posts
    1,166
    Default PPD Reading - went to another
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    How would you code for a PPD reading if the PPD is placed in one clinic and then the patient went to another clinic for the reading?
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  2. #2
    Location
    Columbia, MO
    Posts
    12,571
    Default
    I thought from a standard of care point, only the clinic that administered the PPD can read it, since it needs to be read within a certain timeframe and only the one that administered it has the documentation to prove that date. I see no way to bill it. You cannot use a 99211 for a nurse since the provider in her office is not the one that wrote the order.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    I asked one of our nurses, and she stated that if they didn't "plant" it they won't read it. Besides a billing issue, it's a liability issue for them - they don't have documentation of when it was done and by whom.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  4. #4
    Location
    Overland Park, KS
    Posts
    1,166
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    My thanks to both of you! My thoughts exactly, but my providers were asking so I thought I would see what others thought!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  5. #5
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    What would happen if the patient supplied the documentation? Let's say the patient brought in the form clearly showing when the PPD was placed and when it needs to be read and they are within that time frame? Can this be coded? I realize 99211 is out here, but could you possibly report an unlisted code? Possibly 99199?

    Just trying to look at this from all angles.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  6. #6
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    You can only bill for a nurse's services if those services meet the "incident to" rule. Since he/she is not in the office of the physician who wrote the order for the PPD, I don't see any way that you can bill for the service.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  7. #7
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

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