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Wiki 99211 for nurse
- Thread starter lthomas2
- Start date
CarolP77
New
I have billed 99211 as brief nurse visits, but it has been denied or adjusted off by commercial payer claiming unbundling and is considered part of the injection..
shellysk8
Networker
Bundling 99211
Based on CCI edits, E&M and Preventive Medicine visits are now included/bundled with immunization administration. This edit can be over-ridden by appending a 25 modifier to the E&M/PM code. However, 99211 by definition is not considered a "significant" visit, so adding a 25 modifier to that code is inaccurate coding, and payers will deny 99211 as included/bundled.
Based on CCI edits, E&M and Preventive Medicine visits are now included/bundled with immunization administration. This edit can be over-ridden by appending a 25 modifier to the E&M/PM code. However, 99211 by definition is not considered a "significant" visit, so adding a 25 modifier to that code is inaccurate coding, and payers will deny 99211 as included/bundled.
OCD_coder
True Blue
Just an FYI, the code combination 99211 and 96372 are not billable with a modifier and they won't pay the 99211 even if you have a different diagnosis on it. Simply bill the 96372 or have the provider see the patient to capture any additional services needed beyond the scheduled injection.