Wiki Nurse Visit Billing

[dmccullers]

Our nurses see a lot of our patients for various things. If a patient comes in for a life port check to make sure it is healing correctly is the nurse (RN, LPN, MA) able to charge an office visit? If so how is that billed if they do not have an NPI number. Sometimes there is a physician in the clinic and sometimes there is a Physician Extender. A lot of the time it is dressing changes and packing from a wound. can this be billed? I know we bill for life port flushes and unnaboot changes when the nurse does that, but those have specific codes for that service. I just want to make sure we are billing for everything we can bill for and not billing for things we shouldn't be billing for.

 

[csperoni]

When you are billing for port flushes and the like, you should not also be billing an E/M with a nurse.
Dressing/packing changes are often in the global period and not billable if in global.
99211 may be billed under the physically onsite MD/PA/NP if it meets the incident-to guidelines. https://www.aapc.com/blog/69067-99211-in-2021/

 

[SharonCollachi]

Unless your state has a different scope of practice than mine does, a medical assistant is not qualified to do any of the things you mentioned. "Healing correctly" is a medical judgment, and medical assistants cannot make medical judgments.

 

[csperoni]

Yes, anything performed needs to clearly be within that employee's scope of practice. My state (NY) does not license medical assistants regardless of certification, and does allow unlicensed employees to perform dressing changes among other things (not port flushes since that would require drawing a medication).