Wiki 99211

[Lkelley2]

I have a question on use of 99211. Can this be used to bill for strictly a nurse visit, under the indirect supervision of a physician or nurse practitioner? (Physician/NP not on site)

 

[hewitt]

The code description says, "Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician...." Examples of the use of 99211 are in Appendix C in the back of the CPT book.

 

[cheermom68]

Medicare and some commercial carriers follow "incident to" guidelines which require the physician to be present in the office suite when a service is billed under their NPI number. Since a nurse/medical assistant cannot acquire an NPI to bill under, they must bill under the physician's NPI, therefore when the patient is either Medicare or any other carrier that follows "incident to" guidelines, the physician must be present in the office suite to bill 99211

 

[patrick59]

Documentation

Before you bill the 99211 for the nurse visit, be sure that your nursing staff are documenting appropriately. There are specific components that must be documented to support billing the 99211.