AAPC - Back to school
Results 1 to 5 of 5

Thread: billing 99211 with 93672

  1. #1

    Smile billing 99211 with 93672

    AAPC: Back to School
    Hello: I wondered if anyone knows if it is ok to bill a 99211 with administration code 93672 if the nurse actually checks the patients vitals?

  2. #2


    I will wager an opinion here.

    I will speak from the CMS perspective.

    Per the NCCI Edits, 99211 is considered bundled into 96372. The CCM indicator is 0 meaning you can't break the edit. In other words, 99211 can't be reported in conjunction with 96372 to CMS.

    Generally the services that a nurse would perform when administering an injection (i.e., taking vitals, etc) are considered inclusive of the injection code.

    While CMS does not allow 99211 to be reported with 96372, other payers may allow you to report it if the nurse visit is significant and separately identifiable from the injection itself and you would append modifier 25 to 99211. I would recommend consulting with the payer in question for further guidance.

    Hope this helps and again this is my opinion.
    Last edited by dballard2004; 02-02-2011 at 07:55 AM.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  3. #3


    Per the CPT guidelines written under the code for 96372 it clearly states that a physician should not report 96372 without direct physician supervision. to report use 99211. Only hospitals may report 96372 when the physician is not present.

  4. #4
    Join Date
    Apr 2007
    Columbia, MO


    Yes but you cannot report a 99211 without a physician in the office suite area since it is a physician level you are billing.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Join Date
    Apr 2007


    Check with your carrier as well - I just read in the SC Medicaid Provider Manual that they will allow a provider to bill a 99211 with the 96372; however, BCBS will never pay those two codes together.

Similar Threads

  1. Billing 99211
    By SLKappa in forum Billing/Reimbursement
    Replies: 3
    Last Post: 03-05-2015, 12:33 PM
  2. billing 99211
    By apena in forum Billing/Reimbursement
    Replies: 2
    Last Post: 07-19-2014, 03:13 PM
  3. Billing A 99211
    By bparker315 in forum E/M
    Replies: 1
    Last Post: 10-16-2012, 06:16 PM
  4. 99211 and PT billing
    By bquestell in forum Diagnosis Coding
    Replies: 2
    Last Post: 10-04-2011, 01:32 PM
  5. Billing for 99211
    By hopkins441 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 11-11-2010, 12:28 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.