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Posted By Glinda on 09-20-2001, 18:49:00 in Ob-Gyn
I know we have gone over this before. Please be patient, the more I read the more I get confused.

99211 states may not require the presence of a physician. Usually the presenting(s) problem(s) are minimal. Typically 5 minutes are spend preforming or supervising these services. OK, if a patient comes in for uti, preg test, injection, etc. No doc sees this patient only a nurse. They doucment wt, ht, bp, temp, at least 3 items. Can you bill a 99211 and be ok? If an injection can you use this code instead of the injection code 90782?
On injections they would also document risks, etc..

Can someone help? I want to bill it correctly and get paid and still be in compliance.

Thank you in advance.

Glinda
Comments (4)
Posted By Glinda on 09-24-2001, 11:10:00
Thank you all for your help. I think I may my answer.

glinda
Posted By annie on 09-21-2001, 16:19:00
just fyi i've been billing just an injection when pts come in for depo or
rhogam and one insurance company requests documentation. i sent a letter
detailing what was injected and it's still rejected for more documentation.
for the few dollars that we receive for giving an injection this is really
not worth the time or effort. sometimes i feel like it's a no win situation.
annie
Posted By patricia on 09-21-2001, 14:43:00
In a message dated 9/21/01 3:28:59 AM Hawaiian Standard Time, Janrhcr@aol.com
writes:

<<
> OK, if a patient comes in for uti, preg test, injection, etc. No doc
sees
> this patient only a nurse. They doucment wt, ht, bp, temp, at least 3
> items. Can you bill a 99211 and be ok? If an injection can you use this
> code instead of the injection code 90782?
> On injections they would also document risks, etc..
>
> Can someone help? I want to bill it correctly and get paid and still be
in
> compliance. >>

You might also check with your insurance carriers. Our local BCBS is quite
specific about billing all subsequent Depo injections as 90782 and NOT as
99211. If the service goes beyond the injection, vitals, standard q & a's
(for example, the patient also had a UTI), then they advise us to use 99211
for the nurse's visit but attach a -25 modifier. But, again, this is
specific to this carrier.
Posted By jan on 09-21-2001, 11:00:00
In a message dated 9/20/2001 6:22:44 PM Central Daylight Time,
gmallott@msn.com writes:


> OK, if a patient comes in for uti, preg test, injection, etc. No doc sees
> this patient only a nurse. They doucment wt, ht, bp, temp, at least 3
> items. Can you bill a 99211 and be ok? If an injection can you use this
> code instead of the injection code 90782?
> On injections they would also document risks, etc..
>
> Can someone help? I want to bill it correctly and get paid and still be in
> compliance.
>

Glinda-
If the patient is coming in for a UA for UTI, pregnancy test did the
physician order the vitals taken and was there a medically necessary reason
to take the vitals. That is the key. It can't be just because vitals are
"routine" for every patient. A physician ordered blood pressure check or
weight because there may be a problem that requires more monitoring would be
a 99211.

You should not substitute 99211 for an injection code unless a 99211 service
was provided (not just the injection) and then the injection code becomes a
part of the 99211.

Some people argue that for Depo injections they have to go through this
questionaire before they can do the injection, therefore they bill a 99211.
I am not all that comfortable with that philosophy. Any time a patient comes
in for an injection (B-12, gold, depo, immunizations etc), it is a standard
of practice to go through health questions pertinent to that type of
injection. I believe Melanie addressed this some time back and suggested
only billing the injection fee.

Jan Rasmussen CPC
janrhcr@aol.com
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