Wiki Billing a 99211 with 94610, Breathing Treatment

[pclaybaugh]

We have a practice that wants to bill these two codes together. They documantation states pre and post, so the billing they hope for is 99211-25, 94610, 94610-76 and J7620.

According to documentation the patient came in specifically for the treatment. I believe that we should only bill for both inhalation treatments and the drug. I think the nurse visit is overkill(bill). The documentation is very minimal, no vitals were documented, no ROS, only states that the treatment took place.

Please give me your input. Thanks!

 

[mitchellde]

You are correct you cannot bill a visit level at all when the patient presents for a specific service.

 

[fairies_touch]

99211 and 94640

Thank you for your help!

Brandi Patel, CPC

 

[MarcusM]

http://coder.aapc.com/cpt-codes/94610 indicates:

Report 94610 once per dosing episode.

http://www.ama-assn.org/resources/doc/cpt/10-pulmonary-sleep-manaker.pdf indicates:

Codes 94010-94799 include laboratory procedure(s) and interpretation of test results. If a separate identifiable Evaluation and Management service is performed, the appropriate E/M service code including new or established patient office or other outpatient services (99201-99215), office or other outpatient consultations (99241-99245), emergency department services (99281-99285), nursing facility services (99304-99318), domiciliary, rest home, or custodial care services (99324-99337), and home services (99341-99350), may be reported in addition to 94010-94799.