You Be the Coder:
Be Wary of Billing an E/M Service With Injection Provided by a Nurse
Published on Sun Oct 28, 2012
Question: A nurse at our facility recently provided an injection to one of our patients. We billed 96372 along with 99211. Our claim was denied. Can you tell us what codes we should report for the services provided by our nurse to the patient?California SubscriberAnswer: Answer: You cannot code an E/M service along with the injection services provided by your nurse. As per the Correct Coding Initiative (CCI) edits, 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem[s] are minimal. Typically, 5 minutes are spent performing or supervising these services) is a column 2 code for 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) with the modifier '0' that means that these two codes cannot be reported together under any circumstances.If a supervising provider was present [...]
