EM Coding Alert

Question: Doctor orders blood pressure (BP) check at our nurse’s station. The diagnosis is O10.012 (Pre-existing essential hypertension complicating pregnancy, second trimester). I’m aware that there are some instances we can bill for certain visits/ problems outside of the global package, but I’m not sure if this is one. Normally we would bill 99211 (nurse visit) for BP checks ordered by doctor but performed by nurse. Can I report this?

Vermont Subscriber

Answer: In this case, you would not bill. To bill 99211(Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services), you first would have to have an E/M service, not just a BP check. Secondly, a BP check is integral to each visit with the pregnant patient irrespective of need.