kimberagame
Contributor
If we have patients coming in for a nail trim by a nurse, can we bill 11719? I know it likely won't get paid as not being medically necessary, but I'm just trying to figure out the appropriate way to bill the situation. Our clinic does not send these patients to nail salons as insurance would suggest we should do, and has a foot care clinic every week for anyone providers deem need it. This includes patients who are healthy but simply can't reach or see their feet. If 11719 can only be billed when performed by a provider, would billing 99211 be appropriate? I'm hesitant to bill that for a service that we wouldn't be paid for if a provider did it. Also, I know if there's a code that accurately reflects the service that was performed, you're supposed to use that instead of 99211, but I don't know how that applies if the service in question can't be billed when performed by a nurse.
As a side question. If anyone could tell me how to know if a particular CPT code can be billed when performed by a nurse or MA rather than a provider, that would be very helpful. For instance, I know from various articles that cerumen removal with an instrument can only be billed by providers, but lavage can be billed when done by an MA. Where can I go to just get this information, rather than hoping to find an article talking about it? I've found supervision requirements listed in the physician fee schedule, but they only seem to apply to diagnostic studies.
As a side question. If anyone could tell me how to know if a particular CPT code can be billed when performed by a nurse or MA rather than a provider, that would be very helpful. For instance, I know from various articles that cerumen removal with an instrument can only be billed by providers, but lavage can be billed when done by an MA. Where can I go to just get this information, rather than hoping to find an article talking about it? I've found supervision requirements listed in the physician fee schedule, but they only seem to apply to diagnostic studies.
