Wiki Acceptable to bill?

Create Wiki
T

trarut

True Blue
Messages
813
Location
Columbus, OH
Best answers
0
Looking for opinions re: this scenario:

A patient receives an injection but the service does not meet the criteria for direct physician supervision. Is the drug given still billable even though the drug admin is not?

Thanks in advance :)
 
This is not billable. If you are licensed by your state as a freestanding physician office, then somewhere in that agreement it states that a qualified medical practitioner will be present in the office when a patient is being attended to. A nurse RN or LPN or MA are not qualified to be the only practitioner present when patients are being attended. RNs, LPNs, MAs, in the physician office must have direct physician supervision. Check with your state board of nursing and your state office licensing board.
 
We are a freestanding office which is why I know the administration is not billable since no MD is present. So you're saying that the drug is not billable either in this circumstance?

We've been told previously that 99211 is a viable alternative to the admin code in this circumstance; what's your feeling on this?
 
Billing a 99211 for a nurse encounter requires that the provider be present in the office suite area. The reason the CPT book references this is for the benefit of outpatient facility where they may use a 99211 in the outpatient clinic if there is no physician in the suite for direct supervision.
 
Thanks for the information, I truly appreciate it.

Now to research the state licensing boards. That's always fun!!
 
Yes it can be challenging. Go thru your health and human services division at the state. We have a board of healing arts in Missouri and it is so easy to obtain information from them. you might also start with a local nursing school. Hopefully you will find what you need quickly!
 
You must log in or register to reply here.
Top