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Code 99211 cannot be reported for services provided to patients who are new to the physician. The provider-patient encounter must be face-to-face. For this reason, telephone calls with patients do not meet the requirements for reporting 99211.
Physicians can report 99211, but it is intended to report services rendered by other individuals in the practice, such as nursing staff, medical assistants, or technicians, who must document the visit just as a provider would. Common examples include hypertension or wound checks by a nurse or medical assistant.
CPT® 99211 Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal.
If the sole purpose of a visit to the physician's office is to draw blood or receive an injection, then 99211 should not be billed and only the appropriate injection or blood drawing code should be billed
The visit no longer meets incident-to requirements because there was a change in medication. You may not bill 99211; you may bill only the PT/INR. To bill for the evaluation and management (E/M), the provider must have seen the patient.
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.
CPT® code 99211 is defined by the 2011 CPT Standard Edition manual as: "Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician.
Code 99211 must be billed as if the supervising provider personally performed the service. Documentation should specify: the identity and credentials of the supervising physician and the staff that provided the service. the degree of the physician's involvement.
A: The 99211 E/M visit is a nurse visit and should be used only by a medical assistant or a nurse when performing services such as wound checks, dressing changes or suture removal. CPT code 99211 should never be billed for physician, physician assistant or nurse practitioner services.
CPT code 99211 is often called the nurse visit code. But it's not just for nurses! Many of your practice employees can provide the service.
CPT 99211 Description: An outpatient visit or office visit of an established patient. A qualified healthcare professional (physician or other) may not be required. CPT 99212 Description: An outpatient visit or office visit of an established patient. The visit involves management and evaluation.
For existing patients, the time element was removed from CPT code 99211. For CPT code 99212, time for the encounter will be 10–19 minutes. Tenminute increments are used for codes 99213 and 99214. CPT code 99215 has a 15-minute time frame and is utilized for exams 40–54 minutes in duration.
Beginning with CPT 2021, except for 99211, time alone may be used to select the appropriate code level for the office or other outpatient E/M services codes (99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215). Different categories of services use time differently.
Reporting CPT 99211 can bring additional revenue into your practice. Specific payment amounts will vary by payer, but the average unadjusted 2021 payment from Medicare for a 99211 service was $23.03.