tci Part B Insider - 2004 Issue 25

EVALUATION & MANAGEMENT: Debunk the 99211 Myth - It's Not Just for Nurses

If a visit warrants CPT 99211 , you can recoup an additional $20 or more Although 99211 is often called the "nurse's code," physicians and other personnel should report 99211 if an E/M visit doesn't meet the documentation requirements of the higher-level E/M codes (99212-99215). Coding experts recommend that you report 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 services) if the service meets three criteria:1) Staff Performs...

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