Cardiology Coding Alert

Question: If a patient pays for her medicine and goes to the clinic for the nurse to give the injection, we can bill 90772. But CPT says we should bill 99211 if this visit takes place without physician supervision. We used to bill an E/M code but stopped when we were told at a coding seminar that we could not do this. What should we report?

South Carolina Subscriber

Answer: You should never bill 99211 (Office or other outpatient visit ...) with 90772 (Therapeutic, prophylactic or diagnostic injection ...).

But you can bill 90772 for the injection if a supervising provider is present in the office.

Important: If you have no supervising provider present in the office and this is a Medicare patient, you should count this visit as a nonbillable event.

But if this is a non-Medicare patient and no supervising provider is present in the office, you can interpret "supervising provider" to mean any qualified supervising caregiver who can bill in his own right. This rule would only apply when a registered nurse (RN) is giving the injection, not a nurse practitioner (NP) or physician assistant (PA). In this case, you can report 99211.