How do I bill for a nurse visit and 2 injections? Patient presented for a lab visit (Prolia injection for osteoporosis). During her visit, she asked if she could have a Toradol injection because she was getting a migraine headache. The nurse consulted with the physician and the physician directed the nurse to give the patient the Toradol injection, 30 mg. I tried to bill 99211 (with and without a modifier 25), 96372 (for the Prolia injection), J1885 (for the Tordaol) and 96372,59 (for the Toradol injection). The claim will not drop. Does anyone know how to bill for this lab/nurse visit? Thank you for your help, tmassey
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Wiki nurse visit and injection
- Thread starter masseytc
- Start date
mitchellde
True Blue
The patient presented with a new problem for a scheduled injection. The physician should have examined the patient to determine the need for the injection . You cannot bill a 99211 for a nurse to see the patient for a new problem. The best it gets is the injection for the Prolia. The toradol injection really cannot be billed since the provider did not examine the patient for this problem and there was no plan of care from a previous physician encounter for this treatment.
mitchellde
True Blue
No you cannot as the patient evaluation must be performed by the physician. If there is a plan of care in the chart for the migrane treatment from a previous visit, then you do not meet the criteria for a separate evaluation. If there is no plan of care then then patient would need to be evaluated by the physician to determine the need for the injection.
