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Charging Office visit with planned procedure

  1. #1
    Location
    Augusta, Ga
    Posts
    11
    Question Charging Office visit with planned procedure
    Medical Coding Books
    Can you file an office visit for a patient that comes back for a planned series of injections in the office? I say no but one of my physicians says yes?

    Gayle

  2. #2
    Location
    Columbia, MO
    Posts
    12,526
    Default
    Quote Originally Posted by gedmunds77 View Post
    Can you file an office visit for a patient that comes back for a planned series of injections in the office? I say no but one of my physicians says yes?

    Gayle
    No you cannot as you will not be able to meet the criteria to use the 25 modifier. When it is a planned procedure, the medical necessity for that has already been determined. So you cannot charge for it again. If the patient has a new complaint unrelated to the injection, then you can have an ov
    but you will also have a new dx.
    Last edited by mitchellde; 07-11-2011 at 09:15 PM.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default Incident to
    If a physician has face-to-face office visit that determines series of allergy shots is appropriate, would subsequent office visits for allergy shots be billiable as 99211 so long as all additional requirements for 99211 are met?

  4. #4
    Location
    Columbia, MO
    Posts
    12,526
    Default
    no you use the code for the allergy administration. You do not use the 99211 for a procedure that has a CPT code. All components performed are a part of the procedure including taking vital signs.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Default Thanks
    Hadn't seen the rule for 99211 not for other procedures with cpt codes. Thank you for that clarification.

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