Wiki 99211 - we have always billed

[viveros911@gmail.com]

we have always billed a 99211 with 36415 or injection codes. Recently, Medicare began to require a modifier in order for 99211 to be paid..We have tried both -25 and -90 modifiers to no avail..Anyone else having this problem?

 

[mitchellde]

The problem is you have never been allowed to bill a 99211 with injections or venipunctures. This is stated in the MCM as well as numerous Medicare transmittals, and has been the object of the OIG workplan for approximately the last 5 years.
You cannot use the 99211 if the reason for the encounter is to administer an injection or to draw blood. The nurse is not doing or providing anything that is over above and beyond the service requested.