mrsa screening

I have a note from a nurse and would like help in coding it, if it qualifies for a 99211 or not.
S ; mrsa
Vitals were taken, allergies noted
O; nasla swab taken
A; carbuncle - mrsa
P: mrsa staph scree, will contact pt w/ results after DR reviews results.

Thanks,

MRSA screening

I don't see an E/M service.

mrsa screening

Thanks, the nurse had billed for mrsa only and our coder asked me what I thought about a 99211...it looked a little skimpy to me, but I have not actively coded in a while and am rusty. Thanks!

Yes it does qualify.

Cpt guidelines state " Office or outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physicain. Usually, the presenting problem(s) are minimal. Typically 5 minutes are spent perfoming or supervising theses services." The guidleines on this code are vauge and your SOAP note DOES qualify for a 99211.

mrsa screening

It does qualify? So we should bill 99211 along with the lab handling or something else?

bill as an office visit

You do not have to bill it as an office visit but it does qualify if you want to bill it.

MRSA screening

thanks!

MRSA screening

Here's why I don't think so.

there is a code that more accurately describes the visit: lab handling, 99000. I know: no one pays it. But, it is incorrect to bill a CPT code based on the fact that one will pay and one won't.

I don't see the medical necessity for a nurse visit, and I do see lab handling.

99211

It still fits as a 99211 according to the guidelines. But we can agree to disagree smiles

It confuses me

Does the patient have a carbuncle currently that was being treated (at a prior visit) and the doctor wanted a nasal swab for MRSA to see if the patient was a carrier? if so then I say no 99211-it was just a collection of a specimen with no MDM involved. If the patient had a carbuncle and got antibiotics (no global surgery period involved with no I&D) then a wound check with a nasal swab would be 99211 (although the documentation provided does not support a wound check).
Finally I have to add that after a MRSA carbuncle there is no recommendation to do nasal swabs to look for MRSA carriage- it is now ubiquitous in our environment and treating colonization does not lessen risk of future infection. The primary treatment is I&D (or antibiotics).