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Bundling nurse visit w/ pregnancy test?

  1. Default Bundling nurse visit w/ pregnancy test?
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    Last edited by toshadiane; 11-20-2011 at 08:57 PM.

  2. #2
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    We never bill nurse visits with a UA pregnancy screen. If they are not doing anything else for the patient, the work is already included in the 81025.
    Melissa Tescher, CPC, CPMA, CEMC Compliance and Coding Specialist
    Willamette Valley Professional Services member National Advisory Board 2013-2015

  3. #3
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    Columbia, MO
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    In addition you do not meet the provisions to be able to bill the 99211 for a nurse to be the only provider for the patient. It must meet the incident to provisions and it will not.

    Debra A. Mitchell, MSPH, CPC-H

  4. Default
    The office visit was for a depo injection and there was a longer than normal time period between injections.

  5. #5
    Location
    Columbia, MO
    Posts
    12,570
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    I am not sure what you mean, you said first a 99211 and pg test was there a depo shot also? if so you use injection admin you still do not use a 99211, or am I not understanding the issue?

    Debra A. Mitchell, MSPH, CPC-H

  6. Default
    The nurse visit initially was for the depo injection, but because there it was longer than normal between injections there was a pregnancy test. The claim was submitted with a nurse visit, injection, and pregnancy test. They denied the nurse visit portion of the claim. Is that because both the injection and pregnancy have the nurse visit built into them? Thanks everyone?

  7. #7
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    yes every procedure has some "evaluation and management" work built into the RVU...that includes injections and I would say UAs.... There is no extra work involved in taking a UA that isnt covered by the UA charge itself.
    Melissa Tescher, CPC, CPMA, CEMC Compliance and Coding Specialist
    Willamette Valley Professional Services member National Advisory Board 2013-2015

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