# Depo Shot question



## ascordilis (Dec 18, 2008)

How do you bill for this shot when the patient brings it in themselves? If we provide it(by the nurse) who would it be billed? Thanks! Lisa!


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## Lisa Bledsoe (Dec 18, 2008)

If the patient brings the medication you would code 90772 only.  If you provide the medication you would bill the appropriate J code and 90772.


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## ascordilis (Dec 19, 2008)

Thanks Lisa! If the nurse adminsters- I can also bill the 99211 right?


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## Lisa Bledsoe (Dec 19, 2008)

*No*

No, you can't code 99211 if the reason for the visit is the shot.  Nursing time is built into the adminstration codes.


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## ascordilis (Dec 19, 2008)

OK- thanks Lisa!


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## ascordilis (Dec 19, 2008)

Lisa- what information needs to be documented to bill?


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## Lisa Bledsoe (Dec 19, 2008)

There needs to be a separate _reason_ to bill 99211 (you would need modfier -25).


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## becca12 (Dec 24, 2008)

We have a Routine Injection sheet that we have the nurses file out every time they do an injection.

Rebecca


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## cedwards (Jan 10, 2009)

Just an FYI...90772 was deleted in 2009 codes for therapeutic injections can now be found in the 96365-96379 section of CPT.


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## karey (Jan 15, 2009)

Be careful when using the new injection codes. It states "Physicians, DO NOT use 96372 for injections given w/out direct supervision by the physician. To report use 99211. Hospitals may use 96372 when the physician is not present".  I have to use 99211-FP to bill Medicaid w/ all of our injections and have never had problems. So we'll see how it goes w/ all of the other Ins Co.  


Karey, CPC


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## Jarts (Jan 23, 2009)

Does the nurse need to document a SOAP note when using 99211 for injection only?


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## Lisa Bledsoe (Jan 23, 2009)

karey said:


> Be careful when using the new injection codes. It states "Physicians, DO NOT use 96372 for injections given w/out direct supervision by the physician. To report use 99211. Hospitals may use 96372 when the physician is not present".  I have to use 99211-FP to bill Medicaid w/ all of our injections and have never had problems. So we'll see how it goes w/ all of the other Ins Co.
> 
> 
> Karey, CPC



Where do you see that?

The definition of direct physician supervision simply means that the physician is in the office suite.  The physician does not have to be in the room physically observing the injection...


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## aguelfi (Jan 26, 2009)

It says it in the CPT book under 96372.  
You're right about direct supervision, this is saying if there is no direct supervision....in other words general supervision (the doctor has to be available) doesn't apply and wouldn't be acceptable.


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## Lisa Bledsoe (Jan 26, 2009)

OH!  I see it now!


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## Tami DeLuca (Jan 26, 2009)

*What is Direct Supervision?*

I took the definition below directly from CMS.  Please remember that direct supervision does NOT mean the physician must be present in the same room.


*Direct supervision in the office setting does not mean that the physician must be present in the same room with his or her aide. However, the physician must be present in the office suite and immediately available to provide assistance and direction throughout the time the aide is performing services.*


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## mhoskins (Jan 26, 2009)

*Michalene Hoskins CPC*

prior to 2009 we used 90772 for procrit injections.  If the patient saw the physician the same day we could bill 90772and an E&M with modifier 25.  Since the code changed to 96372 we are being denied payment for it if it is used with and E&M code.  Does anyone know if you can't use both now?  Still trying to get an answer from my local carrier Palmetto GBA.


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## CONSULTA-A-CODER (Jul 19, 2010)

karey said:


> Be careful when using the new injection codes. It states "Physicians, DO NOT use 96372 for injections given w/out direct supervision by the physician. To report use 99211. Hospitals may use 96372 when the physician is not present".  I have to use 99211-FP to bill Medicaid w/ all of our injections and have never had problems. So we'll see how it goes w/ all of the other Ins Co.
> 
> 
> Karey, CPC



The 99211 has beeen a very sticky and unclear code since arriving on the scene. I was wondering how this would apply to a medical assistant. Per CMS it specifes "Nurse. I am not sure if I applies to different states but Wisconsin will not pay for a 99211 for a MA.


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## CONSULTA-A-CODER (Jul 19, 2010)

Jarts said:


> Does the nurse need to document a SOAP note when using 99211 for injection only?



Yes of course. Doumentation should always follow and service provided by any medical provider. MD,RN,MA ect


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