BC Advantage - 2021 Issue 10

When is it Proper to Bill Nurse Visits Using 99211?

When vaccines or injections are given in the office, coding can often get confusing; for example, is it correct to report a nurse visit using 99211 and an E/M office visit reporting 99202-99215 and include injection fees with the vaccine product? In addition, the reporting of evaluation and management (E/M) during the same visit where vaccines are administered is not always understood. The answer depends on whether the provider performs a medically necessary and significant, separately identifiable E/M visit, in addition to the immunization administration.CMS states, when a separately identifiable E/M service (which meets a higher complexity level...

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