Wiki Vaccination and Injection Billing

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wscallorn

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Tennessee Chapter
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I hope someone can help with my question. My provider states I can bill for vaccinations or injections given by the nurse under him when he is out of the office. My understanding is as follows only the medications can be billed. I can not bill for an office visit or administration fee unless he is in the office. His argument is the Shot Nurse gives shot's without an MD or mid-level in house and bills insurance. :confused:
 
Hospital is different from a physician office. You are licensed by the state as a physician office. If you check with your state you will find that a physician (or NP) is required to be onsite when patients are in the office.
 
Debra,

Thank you for your response. Can you guide me as to what I research for in order to obtain this information? I will need to produce it in writing for policy to change in the office. Thank you again!
 
Check with you state board of nursing as well as your physician office licensing agency. also remember you must use an NPI in field 24J which indicates the rendering or supervising provider, since nurses have no NPI and the provider is not in the office, you have no rendering or supervising NPI to use. In addition when you check with the nursing board you are looking for the term direct supervision in the physician office setting. this is how nurses may render care, direct supervision means the physician must be physically present.
 
I have a question along the same line... Patients are scheduled to come into the office for a testosterone injection, a BCG instillation or TNS procedure there is a Nurse Practitioner in the office but no physician. We would bill under the Nurse Practitioner's NPI correct?
 
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