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99211 - We are a family practice clinic

  1. #1
    Default 99211 - We are a family practice clinic
    Medical Coding Books
    We are a family practice clinic with a hugh debate going on. We just had a patient present for an ear lavage, when the nurse looked in the ear, it was red, she then called the physician who also looked in the ear, offered antibiotics, which patient turned down, and then the nurse lavaged the ears. Our biggest thing going on here is when do you charge for a 99211 for strictly nurses services, even if they are supervised by physicians. We do a ton of blood pressure checks and ear lavages without the physician being present. We are just unsure about the documentation requirements for the 99211. What scenario's do other offices use to charge a 99211? We are interested in hearing from other offices. Thanks in advance for your opinions.

  2. #2
    Default
    We use 99211 sometimes in our office but not very often. We only use it when a work comp comes in and needs a refill on their meds and it is not time for their re-check, becuase we dispense the meds to them. But I found an article for you that may help. It talks about checking the blood pressure at the end.

    http://www.aafp.org/fpm/20040600/32unde.html

  3. Default
    I know it can be boring reading however I have the information within the chapter below very useful.

    http://www.cms.hhs.gov/Manuals/IOM/list.asp

    100-04 claims processing manual
    Chapter 12 - Physician/Practitioner Billing

    Also, I would check with your carriers and make sure you can bill nurse visit and their requirements. Because I know for BC of AL, you are not suppose to bill 99211 as a nurse visit. They do not allow any indicent-to (or doctor protocol). Only services the doctor personally performs are to be billed under the doctors provider #(NPI#).

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