Reader Question:
99211 Has Limited Role in Coumadin Encounter
Published on Tue Aug 16, 2011
Question: We're trying to create a policy on when to report an E/M code when a patient presents for Coumadin monitoring. Are there any official rules on this?Virginia SubscriberAnswer: Your Jurisdiction 11 Medicare Administrative Contractor (MAC), Palmetto GBA, offers the following guidelines on reporting 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem[s] are minimal. Typically, 5 minutes are spent performing or supervising these services) in addition to venipuncture for drug treatment monitoring.First, to report 99211 in addition to the venipuncture code, the licensed auxiliary personnel must perform a face-to-face service. As part of that service, the provider must document one or both of the following:"A minimal presenting problem/symptom""A relevant and necessary exchange of information between licensed personnel and the patient."If the service and documentation don't meet the above requirements, you [...]