Ob-Gyn Coding Alert

Question: When our ob-gyn gives a standing order for an injection, can we code 90772? The ob-gyn is in the office suite, and the patient sees the nurse only. From my understanding, we shouldn't code with standing orders. If the nurse gives the injection, the office uses the administration code. Is this correct?

Georgia Subscriber


Answer: If the nurse gives the injection and the physician is in the office at the time, you can only report 90772 (Therapeutic, prophylactic or diagnostic injection [specify substance or drug]; subcutaneous or intra-muscular). CPT also states that if the physician is not in the office at the time of the visit, you should instead 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 -).

Watch out: If this is a Medicare patient, you will not be able to bill anything if the physician was not in the office under the -incident-to- rules.

Also, don't get caught up with the term -standing order.- A physician must order an injection for a patient. A standing order just means that the ob-gyn has ordered it for any patient who meets certain criteria. That has nothing to do with billing for it.