Primary Care Coding Alert

Question: A patient came to our office for a flu shot. The physician ordered the LPN to check the patient's blood pressure while he was in the office because of some prior conditions. Would this blood pressure check qualify for 99211?

Answer: Yes, this scenario would support reporting 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician ...).

Support: If you look in the clinical examples of Appendix C in CPT, one includes a 45-year-old female who comes to the office for a blood pressure check under 99211. If the patient's prior conditions include high blood pressure (401-405, Hypertensive disease) or a similar condition, the blood pressure check is likely medically necessary.