tci E/M Coding Alert - 2020 Issue Q4

You Be the Coder: Don’t Be Out to Lunch Coding This Incident-To Scenario

Question: We reported 99211 for a nurse visit with a Medicare patient when the provider was out at lunch. My office manager said we can’t report it that way, but we aren’t sure if that’s true. Can you advise? Pennsylvania Subscriber Answer: The office manager is correct. For Medicare claims, the physician must physically be in the office at the time of the service. They don’t necessarily have to be right by the nurse’s side, but they have to be somewhere in the office suite for you to report 99211 (Office or other outpatient...

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