mgrenz
New
Although I am pretty confident in my answer(s), I am looking for some additional support about when and when not to bill a 99211.
First Example - Multi-specialty group. Patient is only established with Endocrinologist in the practice but comes into family practice (non-established in primary care family practice) and is seen only by an RN for non-symptomatic STI screening or sore throat can a 99211 be billed under Primary Care standing order and the primary care family practice provider - My answer is no as it does not meet the incident to with the order/billing provider of family practice that they have not established with.
2nd example. Patient is established with primary care/family practice and comes in for triage appointment (new problem) and does not see the provider but nurse triages complete vitals, history, exam and prescribes home care maybe does a swab or UA does this meet a 99211? My answer is no because there is not an order from the established primary care/family practice provider(s) nor ongoing treatment of condition as this is a new "problem" and needs to be evaluated by a MD/NP/PA.
3rd example: Patient is established with primary care/family practice and provider orders weekly weight checks for eating disorder and patient sees nurse only can this be billed a 99211? My answer is yes.
4th example: Patient is an established patient with primary care and has been seen for multiple concerns one being sexual health. Provider has a standing order for asymptomatic STI screening and patient is seen by nurse only for safe sex practices counseling and STI testing. My answer is yes. As per the AMA article "Rn Billing and Coding FAQ Common uses for the 99211 code" in a STD site are: asymptomatic urine STD screening, stand-alone HIV counseling and testing, chlamydia treatment with a previously written order, or retesting after
treatment for chlamydia or gonorrhea.
First Example - Multi-specialty group. Patient is only established with Endocrinologist in the practice but comes into family practice (non-established in primary care family practice) and is seen only by an RN for non-symptomatic STI screening or sore throat can a 99211 be billed under Primary Care standing order and the primary care family practice provider - My answer is no as it does not meet the incident to with the order/billing provider of family practice that they have not established with.
2nd example. Patient is established with primary care/family practice and comes in for triage appointment (new problem) and does not see the provider but nurse triages complete vitals, history, exam and prescribes home care maybe does a swab or UA does this meet a 99211? My answer is no because there is not an order from the established primary care/family practice provider(s) nor ongoing treatment of condition as this is a new "problem" and needs to be evaluated by a MD/NP/PA.
3rd example: Patient is established with primary care/family practice and provider orders weekly weight checks for eating disorder and patient sees nurse only can this be billed a 99211? My answer is yes.
4th example: Patient is an established patient with primary care and has been seen for multiple concerns one being sexual health. Provider has a standing order for asymptomatic STI screening and patient is seen by nurse only for safe sex practices counseling and STI testing. My answer is yes. As per the AMA article "Rn Billing and Coding FAQ Common uses for the 99211 code" in a STD site are: asymptomatic urine STD screening, stand-alone HIV counseling and testing, chlamydia treatment with a previously written order, or retesting after
treatment for chlamydia or gonorrhea.