Wiki Bill 99211?

[ivygirl18@hotmail.com]

Can we bill a nurse visit for the following scenario? A patient presented to ask questions about gastric bypass surgery. One of the MA's in the office met with the patient and spent time answering her questions. The office would like to know if they can bill a nurse visit. MA is documenting a NN regarding the discussion, but I am not sure if 99211 can be billed for services by non-clinical staff or must it be an RN or LPN.

Thank you,

Abby Ronco-Hopkins, CPC

 

[thomas7331]

In order to bill a 99211, the services performed have to meet the definition of E&M done incident to a physician's service - the services must have been ordered by the provider and be part of that provider's plan of care for the patient, and it needs to be some kind of evaluation and management of a patient's condition. 99211 is not limited to just nurses - an MA can bill for this too - but they have to be carrying out a physician's order. If they are just answering questions for a patient who has come in, that by itself would not qualify.

 

[ivygirl18@hotmail.com]

That makes sense. Do you have a source that I can reference?

Thank you

 

[thomas7331]

There are a lot of good articles and webinars out there about this, but here's a job aid published by the Medicare contractor in my area that I think is a particularly good reference:

https://www.ngsmedicare.com/ngs/por.../?clearcookie=&savecookie=&REGION=&LOB=Part B

 

[ivygirl18@hotmail.com]

I can not pull up the article. It wants me to log in.

 

[thomas7331]

I can not pull up the article. It wants me to log in.

You don't need to log in, you should be able to select 'continue as a guest' and just indicate you're a Part B and select a region.