Medicare Compliance & Reimbursement

Just because 99211 is known as a 'nurse visit' doesn't mean you can report it without the appropriate notes. When your practitioner performs a level-one established patient E/M service, you probably report 99211 without much thought, because the so-called "nurse's code" only pays about $19.00. However, you should put just as much effort into ensuring that you're reporting 99211 as accurately as your other codes. Not only is it compliant and correct coding to do so, but MACs are watching. WPS Medicare, a Part B payer in Illinois, Michigan, Minnesota, and Wisconsin, recently updated the results of its CERT review, noting that it found several errors among the claims for 99211 -- most of which related to a lack of thorough documentation. For instance, the CERT reviewer commented that a chart only included documentation of a prothrombin anticoagulation check, with no notes about an E/M visit, but the practice billed both [...]