What documentation is needed for 99211?
The presence of a physician is not required in the exam room. Unlike other E/M codes, CPT 99211 does not have any documentation requirements for the history, physical exam or complexity of medical decision making, however, supporting documentation in the patient record is required.
Who can report CPT code 99211?
Physicians
Physicians can report 99211, but it is intended to report services rendered by other individuals in the practice, such as a nurse or other staff member. Unlike other office visit E/M codes, a 99211 office visit does not have any specific key-component documentation requirements.
Is 99211 covered by Medicare?
Does Medicare Approve 99211? Yes, Medicare considers this routine. If you are an approved Medicare provider you can bill this code.
What is included in CPT 99211?
Code 99211 describes a face-to-face encounter with a patient consisting of elements of both evaluation (requiring documentation of a clinically relevant and necessary exchange of information) and management (providing patient care that influences, for example, medical decision making or patient education).
What does CPT code 99213 stand for?
Office or other outpatient visit
CPT Code 99213: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a low level of medical decision making.
Who can bill for 99213?
CPT Code 99213 can be utilized for a mid-level outpatient or inpatient office visit. CPT Code 99213 is a level three code that should be used for an established patient. It cannot be used with a new patient who has no history.
Does 99211 need a 25 modifier?
99211 is a -25 modifier eligible code so that other services can be billed when the use of the modifier is allowable. 99211 can be used for a medication refill IF the Physician/Practitioner is providing on-going management for the patient.
Who is allowed to do a 99211?
Any qualified ancillary person under the employment and direct supervision of the physician may provide services that qualify as a 99211. Basically if the service has been ordered by the physician in a previous encounter and is physically in the office at the time of service, and there is no CPT or HCPC II code that can be used to describe the service provided then you can use the 99211.
Who can Bill a 99211?
Under Medicare law, only physicians and specified non-physician practitioners (nurse practitioners, clinical nurse specialists, physician assistants and certified nurse midwives) (“NPPs”) can bill for 99211 and any other E/M services which are medically necessary.
What is CMS billing?
CMS in medical billing stands for Centers for Medicare and Medicaid Services, an agency of the U.S. Department of Health and Human Services. Formerly called the Health Care Financing Administration.