Wiki 99211 on same day as injection

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AKAJBART

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Please help me settle a dispute between myself and the CEO & Physician in my office.

A patient came in for her scheduled Depo injection. A pregnancy test was ran in our lab, and was negative (per office protocol). Doc wants to bill a 99211 in addition to the Depo shot and administration and HCG lab.

I don't see that it's separately identifiable indication for the level 1 office visit, however... am being asked to provide proof of why.

99211 - YES or NO???? And why...... PLEASE!!

Thanks,
Kristi
 
No to the 99211, there is no separate office visit documented, only the reason for the encounter which is included in the injection administration.
 
That's exactly what I said, but was told that there was medical decision making done when the pregnancy test was ran and came back negative.

Plus because they automatically check all of the template on the Exam, it looks as if a complete exam was done. Which is entirely fraudulent.
 
It does not represent decision making, the test is done as a routine prior to the admin of the injection, which makes it a part of the injection and not distinct and separate. As far as the templet being filled not, it does not matter, while a comprehensive visit CAN be documented at any time, it should NOT have been done for this visit, the medical necessity does not support a visit of any level.
 
Couldn't agree with you more!! Thanks for the support. :D

They just want to argue back and forth about it, and make it look as if I'm making them lose $$ by not billing what they tell me to. It's very frustrating!!!! Instead they should be thanking me for saving their butts!!!
 
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