tci E/M Coding Alert - 2023 Issue Q1

Reader Questions: Don’t Rely on Single Code for Nurse-Led Encounters

Question: Should I be reporting all services performed by a nurse, including those provided to new patients, with 99211? Alabama Subscriber Answer: While 99211 (Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a provider or other qualified health care professional) does not require history, exam, medical decision making (MDM) or the presence of a provider, automatically reporting services provided by a nurse with 99211 is not correct and could result in audits and revenue loss for your practice. First, look at the code descriptor itself, which...

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