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testing only visits and 99211

  1. #1
    Question testing only visits and 99211
    Medical Coding Books
    I have always been under the impression that 99211 is bundled with most ophthalmology testing codes (92083, 92133, 92134, 76514, etc). Can anyone confirm/deny this, and show me where to find proof in layman's terms to give to the techs? These are for visits where the patient only sees the tech, and the tech only performs the tests in question.

    Thanks.

  2. #2
    Location
    Columbia, MO
    Posts
    12,531
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    The tests have built into them the time and expertise of the tech to administer the test. You cannot just tell the patient to go into the room and do the test so the administration of the test is already factored in. The provider has already billed for his expertise to determine the test is needed. Therefor there is not need for the 99211 and to use it would be double dipping.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default
    Thanks for your response, Debra, you reconfirmed what I have been telling the techs. Since my post I have found the proof I was looking for, and the techs have stopped circling the 99211 code.

  4. Default
    What if the OD is reviewing the OCT that the techs did. Do you apply a modifier? If so, which modifier would I use? I have noticed Medica is denying claims that have 99212 and 92134 or 92133 billed on the same date of service.

  5. #5
    Question Can an OD bill a regular E/M code?
    I have an issue similar. Opticare is denying for Pink Eye & Contact dermatitis (don't know why OD used a dermatitis code-it's not mentioned) Can an OD bill a regular E/M code if it's part of a "HUB" (Pedi, Fam, Adol, Senior, Dental & Optical under 1 roof) we bill under site NOT by provider. I've never worked with Vision before and I'm confused.
    Kelly L Salerno, CPC

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