tci General Surgery Coding Alert - 2003 Issue 3

Medical Necessity Is Critical for 99211 Reimbursement

Do patients come into the office for blood pressure checks or other brief E/M services on days they don't see the surgeon? If so, your general surgery practice can bill Medicare and some private insurers for many of these "nurse-only" visits (99211) if your nursing and nonphysician practitioner (NPP) staff know how to provide and document the services. Remember, report 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem[s] are minimal. Typically, 5 minutes are spent performing or supervising these...

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