Ob-Gyn Coding Alert

Learn what will turn a nonreportable service into a nurse visit

If you think coding nurse visits is a snap, you might be in for a surprise.

Check out four common ob-gyn scenarios and determine whether you should report 99211 under these circumstances:

1. A patient drops off a urine specimen.

You shouldn't charge 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician ...) for a urine specimen drop-off because the nurse doesn't perform an E/M service. For the specimen handling and conveyance, however, you may be able to report 99000 (Handling and/or conveyance of specimen for transfer from the physician's office to a laboratory).

2. A patient presents for a blood draw.

If the patient comes in only for a blood draw, you should charge 36415 (Collection of venous blood by venipuncture) instead of 99211. But you may report 99211 if the nurse takes the patient's history or documents a chief complaint. Some carriers, however, may bundle the E/M service with the venipuncture code or vice versa.

3. A patient picks up a prescription refill from the receptionist.

Don't bill 99211, because your practitioner didn't perform a face-to-face visit and, therefore, did not document an E/M service.

But you may report 99211 when the patient presents with a problem that requires the provider's services. For example, a patient comes in to pick up her birth-control refill and tells the receptionist that the medication causes some unpleasant side effects. The nurse documents the problem and checks with the ob-gyn regarding changing the patient's dose. Because the service involves the nurse and a problem, you can report 99211.

4. A nurse administers a Lupron injection.

Usually, the administration code (90782, Therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular) covers the nurse's work, so you shouldn't submit 99211 as well.