Wiki Nurse visit for a TB test administered

[anita lapointe]

Hello..

I have a nurse visit where a TB test was the only thing done. There were no vitals documented, only the documentation of the TB test being given with instructions to come back 2 days later for the test to be read. How would you code this? A person in my billing department wants me to put E/M of 99211. Would that be appropriate? Thanks

 

[thomas7331]

You've answered your own question - if there was nothing else done, there is nothing else to bill. A separate E&M service would require documentation that such a service took place, and it also must be a specific service that the provider ordered as part of their plan of care.

 

[Pathos]

A procedure code usually includes a low level E/M when billed. Like you're saying, if there's nothing else done, then nothing else should be billed out.