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Thread: Labs & Copays

  1. #1
    Join Date
    Apr 2007
    Maryville Illinois

    Cool Labs & Copays

    AAPC: Back to School
    Our office use to charge a nurse visit (99211) to ALL patients coming into the drs office to have labs only. It was discovered this was unacceptable for Medicare patients as this could only be charged if a Dr. was on site.

    Is it acceptable to bill private party insurances the nurse visit in addition to the labs which would require some to have a copay or do the same rules that Medicare follows apply?

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    There is no rationale to charge a 99211 for labs. A code exisit for blood draws and that is the code to use. This is preplanned for the patient to come to the office for this service. An E&M may not be charged when the patient has already been evaluated at a previous encounter for the necessity of the planned procedure, in this case a blood draw. Performing vital signs is not justification for a 99211, for all payers you should bill the blood draw and the lab codes only.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Join Date
    Apr 2007
    Evansville Indiana

    Default 99211

    I totally agree with Debra. And even if the MD were in the office it would still not be billable.

  4. #4


    i wanted to know if when pt asks for a copy of thier labs and the doctor has not signed. are we allowed to give them a copy without a signature?

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