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99211

  1. #1
    Default 99211
    Medical Coding Books
    Can you bill an E/M of 99211 when a pt comes back to have a TB test read? I thought I read some where that you could, but I can't seem to find where I read that at. Any thoughts?

    Thank you to those who respond!!!!
    Last edited by kmaher; 09-18-2008 at 12:52 PM.

  2. #2
    Default
    No, it is not proper to bill a 99211. The reading is included in the TB code.

    Now, if it's positive - that obviously requires an E/M service by the provider.

  3. #3
    Location
    North Carolina
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    Ok...let me throw a curve ball.

    In the back of your CPT book, it provides clinical examples of E/M codes.

    99211=Office visit for a 42 year old, established patient, to read tuberculin test results.

    What's your interpretation of this? I'm signed up on other coding forums and this question is asked often and this except is often referenced.

  4. #4
    Location
    Duluth, Minnesota
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    1,133
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    I say,... I read it.. but that we never charge an E/M when they come back for the read. (but apparently you can)
    Donna, CPC, CPC-H

  5. #5
    Default
    my Expert edition doesn't have examples, let me pull the Professional edition.... be right back

  6. #6
    Location
    North Carolina
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    Once I get on a roll...it's hard for me to stop. I found this, also.

    http://medicalnewswire.com/artman/pu...cle_7160.shtml

  7. #7
    Default
    I read it but... I just don't agree.

    Here's a few references I have found:

    Trailblazer (Medicare) - specifically states it is included.
    http://www.trailblazerhealth.com/Too...s.aspx?ID=5442

    These people say the same too...
    http://www.physicianspractice.com/in...s/qaID/204.htm

    Let me add:
    If you spend significant time with a patient reviewing the results or providing instruction, it would be appropriate to report those activities using an E&M code; you would select the level of E&M codes based on the E&M coding requirements. (From the second link above)

    Simply looking for 2 seconds and saying negative - doesn't support a 99211.

    Also, keep in mind, some insurance plans will apply a copay to the 99211 because it's an evaluation and management service - whether it's MD or not -I would be pretty ticked if I got a bill for 20 bucks for 2 second service to tell me something I already knew, that it was negative.
    Last edited by ARCPC9491; 09-18-2008 at 12:52 PM.

  8. #8
    Location
    North Carolina
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    3,126
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    Although we don't charge for the reading, it does create a margin of question. I do agree that it would create bad PR if the patient was charged for the reading and a copay was applied. I think it's safe to say that we all agree.

  9. #9
    Default
    Yes I agree! I would love to hear from the practices that do charge for it, what their experiences are with the insurances and their patients.

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