Wiki CPT 99211-Nurse Visits

[jaud63]

Does anyone know where I can find policy information specific to the regulations of
billing for nurse visits. I work in a Pulmonary/Sleep Medicine clinic with nursing staff
that are not registered nurses (CMA's, MA's) and patients frequently return for CPAP mask
refits, nebulizer treatment instructions, etc.
I have been unable to find information that states that the 99211 code cannot be billed by these types of credentialed nursing staff, however, I have always been under the impression that an RN must be the one providing the service to use this code.

 

[klebart123]

Clarification from CPT



99211 is not just for RN use only. The CPT book states, "may not require the presence of a physician or other qualified health care professional". The key word here being "may".

You're probably looking for more information than that, but hope that helps.

 

[jaud63]

CPT 99211-Nurse visits

Yes. I'm wondering what Medicares definition of "qualified" is. Thanks for you help.

 

[debflutter]

Seet this article by AAFP http://www.aafp.org/fpm/2004/0600/p32.html