Wiki HELP! Two E/M codes on the same day???

[scunningham]

I'm wondering how to code this... Any thoughts or suggestions would be helpful!

A patient comes in to see the doctor for a follow-up. I code an E/M code 99214.

The same patient, then gets blood taken from the nurse directly after the visit with the doctor, in the same office for long term (current) use of anticoagulants.

I feel like the second "visit" (they have two different invoices on separate lines for billing) can only be coded as a 36415 for collection of blood by venipuncture.

Does that seem correct or should the nurse be getting paid separately with a 99211 and 36415??

 

[ttglasscock]

You would code for the office visit and the venipuncture. It is only one visit with a lab draw.

99214 with 36415

 

[mitchellde]

This is all one visit. You never use a 99211 for a blood draw since the 36415 covers that activity. 99211 is not a nurse level it is a provider level . Even if the only reason the patient is there is for the blood draw you still charge only the 36415. The 36415 captures all of the nursing function of performing the veinipuncture which includes taking the vitals.

 

[dingersol]

You would code for the office visit and the venipuncture. It is only one visit with a lab draw.

Agree 100% - only one office visit and veinpuncture based on scenario you posted.

Only time you can bill a 99211 for anticoag is if the nurse is truly providing an "incident to" visit and following a clinic or provider set treatment plan for the patient. If the MA or nurse only does venipunture that is not a 99211.

But this would not apply on same day if a provider billed for a 99214 in the same clinic.