Wiki 99211, Dressing Changes, and NPs

[dballard2004]

I audit for the retail clinic side (among others) and this question has come up...

A patient comes into the clinic with an open wound. We treat it (cleaning, wound dressing, maybe even ab if there is some cellulitis), and they're following up for recheck. Since cleaning, wound dressings, and possibly prescribing an ab is not surgery, and the patient presents for a wound check and a dressing change, what E/M code would we use here? I guess what I'm asking is can we report 99211 if the service is being done by an NP and no physician is onsite?

 

[FTessaBartels]

Documented level of service

An NP is perfectly capable of documenting any level of E/M service. Code what was documented - under the NP's name/number.

F Tessa Bartels, CPC, CEMC

 

[dballard2004]

I kinda of thought that as well, but if it is Medicare, we would have to meet "incident-to" requirments to bill the 99211 correct?

 

[FTessaBartels]

NO

If the physician is not in the office suite ... just bill the NPs documented level of service 99201-99215 as appropriate and documented. Bill under NP name/number ONLY.

F Tessa Bartels, CPC, CEMC

 

[dballard2004]

Thanks.