tci E/M Coding Alert - 2020 Issue Q3

You Be the Coder: Know How to Avoid This Incident-to Error

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? Arizona 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 building for you to report 99211 (Office or other outpatient visit...

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