Primary Care Coding Alert

Question: Patients who are new to insulin come to our office for teaching visits. A nurse spends 30 minutes teaching the proper aseptic injection technique and discussing the use of insulin. This encounter seems to go beyond services described in 99211. How should we code this?

Alabama Subscriber

 
Answer: Although the typical time for 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician ) is five minutes, it is not limited to quick in and out visits. Code 99211 was developed to reimburse for care usually provided by a registered nurse, licensed practical nurse or certified medical assistant. The teaching of aseptic injection techniques to new diabetics is the kind of service that 99211 is intended for and is the most appropriate code for billing these services.

  Answers to You Be the Coder and Reader Questions provided by Judy Richardson, RN, MSA, CCS-P, senior consultant at Hill & Associates, a coding and compliance consulting firm based in Wilmington, N.C.; and Kent Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians.