tci General Surgery Coding Alert - 2003 Issue 3

Reader Question: 99211 Isnt Just for Nurses

Question: We employ a physician assistant (PA) who performs all levels of E/M services. We recently noticed that if he sees a patient just for a blood pressure check, he bills 99212. We think hes upcoding because those visits only require 99211. He says 99211 is for nurses only. Who is correct? Georgia SubscriberAnswer: Your PA is incorrect. Just because 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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