Wiki coding 99211

[sreelaly2k4@yahoo.co.in]

Please clarify regarding 99211..

scenario:1

Patient A visited the physician B on 04/08/2012 for her menstrual disorders
And the doctor prescribed menagon injection 4 ampules on the following days
05/08/12, 06/08/12, 07/08/12, 08/08/12.

can we submit the claims with 99211 and menstural disorders as the Dx??

Scenario: 2

Patient C visited the physician D on 31/07/12 for her menstrual disorders.
And the doctor prescribed menagon injection 4 ampules on the following days
05/08/12, 06/08/12, 07/08/12, 08/08/12.

Since its not a revisit,can we bill with 99211

And what are the documentation required for furnishing a 99211 visit????


please clarify,

Regards,
Sreelal V.S MSc,CPC

 

[mitchellde]

Your 2 scenarios are identical, if you asking about the injection visits then no you cannot charge a 99211 to give an injection, you charge injection administration and the the drug only. If you are asking about the initial encounter, then there should be physician documentation to support a visit level, if it only supports a 99211 then of course you bill that.
Documentation for a 99211 must support that this is a physician encounter with the patient. If this is a visit with ancillary personnel, then there must have been a visit prior with the provider for this diagnosis where this follow up activity was ordered and the provider must be present in the office suite. If the ordered activity can be coded with a distinct CPT code (such as injection administration) then you cannot use the 99211. The "nurse" is not providing a significant evaluation beyond what is required for the procedure.