# Can't I bill 99211 with 86318?



## Katwood (Jul 11, 2011)

I've received a denial from Medicaid for billing 99211 and 86318.  The patient was seen by a medical assistant for a rapid strep test.  Medicaid is telling me that billing these together is unbundling.  I thought that the 86318 was for the test only, and that the 99211 was for administering it.  If you can please include some references to go with your responses - I need to get info for a hearing request.

Thanks!


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## mitchellde (Jul 11, 2011)

If the only reason the patient was in for for the administration of a rapid strep with no face to face visit with the physician, then you cannot bill the 99211 as the incident to provisions have not been met.  To use a 99211 for ancillary personnel it must a followup encounter as ordered by the physician in a previous encounter for the same reason, have had strep in the past does not count.  And the provider must be onsite.  So a visit for a rapid step is the code for the lab only as there has been no face to face involvement by the provider.


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