Wiki 99211 or 96372

[nikki_coder]

What's the most appropriate way to bill for a depo shot administered by an NP in an outpatient hospital facility (POS 22)? Any comments are helpful.

 

[thomas7331]

The drug administration code would most appropriate. If the NP performed and documented evaluation and management of a patient's condition distinct from simply performing the injection, they would bill 99212 since it involved a face-to-face encounter. 99211 would be only for ancillary staff performing an evaluation, e.g. evaluating and treating a wound. For either code, in a hospital setting, the NP would need to bill under the own provider number - 'incident to' billing is not allowed.

Thomas Field, CPC, CEMC