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Thread: Pt Not Seen 99211?

  1. #1

    Default Pt Not Seen 99211?

    AAPC: Back to School
    If a patient presents to the physician office and is triaged by nurse and leaves without been seen by the provider, how do you report this?

    Would this be a 99211? I'm not sure if this patient is new or established.

    If they are established, can we report 99211?
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  2. #2
    Join Date
    Apr 2007

    Default Reference this article.

    This link has a great article on the CPT code 99211. It states what constitutes being able to use it as well as some examples. http://www.aafp.org/fpm/2004/0600/p32.html I would give the answer, but how do we learn with only the answers submitted?

  3. #3


    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  4. #4
    Join Date
    Apr 2007
    Columbia, MO


    I tried the link above and nothing ever came up. But you cannot charge a 99211 for a nurse to triage a patient, as it does not meet the incident to parameters. A nurse cannot charge for her encounters. 99211 is a physician encounter which the physician is allowed to charge when qualified ancillary persons are the ones face to face with the patient carrying out physician orders from a previous visit. You must have the physician plan of care for this visit in the chart and the provider within the office to be able to charge the 99211. It does not sound like this is the case in your example.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5


    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

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