Per Medicare Compliance and Reimbursement magazine, "with a 99211 there must be some sort of evaluationand management of the patient and simply taking vitals and giving meds doesn't support the 99211 unless it's part of a previously established plan of care."
My question in two fold: My understanding is that the evaluation and management of a patient comes before the 99211 with the physician or provider initailly establishing care for the patient and the 99211 is an incident to, or therafter visit for that diagnosis and that it cannot be used if any other code is available, and/or unless there is a new issue that has arisen.
Also, vitals and all would never substantiate a nurse visit because it should always be part of an established plan of care previously managed (unless, of course there is no other code available).
Anyone out there shed some light on this further?
Thank you.
My question in two fold: My understanding is that the evaluation and management of a patient comes before the 99211 with the physician or provider initailly establishing care for the patient and the 99211 is an incident to, or therafter visit for that diagnosis and that it cannot be used if any other code is available, and/or unless there is a new issue that has arisen.
Also, vitals and all would never substantiate a nurse visit because it should always be part of an established plan of care previously managed (unless, of course there is no other code available).
Anyone out there shed some light on this further?
Thank you.