venipuncture and BP check

When a patient with hypertension comes in for bloodwork, and I have the MA check their BP - can that be billed as a 99211+venipuncture? If so, given that BP control should be based on multiple values, wouldn't it make sence to always check BP anytime a patient with HTN comes in the office for a preappointment blood draws?

99211

Only if the physician ordered a return because BP was abnormal, for recheck. There must be an incident-to service rendered due to an abnormality.

if abnormal

If the MA looks at the patients last BP when in office and if it was >140/90 (hence abnormal), and if we have a standard protocol in office that if BP was abnormal, to repeat when next in office (which would typically be when they come for routine bloodwork) - would that meet the criteria?

99211

The following guidelines can help you decide whether a service qualifies for 99211:

The patient must be established. According to CPT®, an established patient is one who has received professional services from the physician or another physician of the same specialty in the same group practice within the past three years. Code 99211 cannot be reported for services provided to patients who are new to the physician.
The provider-patient encounter must be face-to-face. For this reason, telephone calls with patients do not meet the requirements for reporting 99211.
An E/M service must be provided. Generally, this means that the patient’s history is reviewed, a limited physical assessment is performed or some degree of decision making occurs. If a clinical need cannot be substantiated, 99211 should not be reported. For example, 99211 would not be appropriate when a patient comes into the office just to pick up a routine prescription. While the physician’s presence is not required at each 99211 service involving a Medicare patient, the physician must have initiated the service as part of a continuing plan of care in which he or she will be an ongoing participant. In addition, the physician must at least be in the office suite when each service is provided. The reason for this difference is that Medicare considers these services to be an integral although “incidental” part of the physician’s professional service.

Example: A patient comes to the office for a blood-pressure check. If the visit was scheduled at the request of the physician, 99211 should be reported because the physician wants to monitor an abnormal reading. Medicare does not like "standing orders". The visit must be linked to a previous visit performed by the physician where patient was instructed to return for BP check. Decisions will be in the "eye of the beholder" if audited.

thx

thank you very much for the detailed reply. It answers my question.

99211

great

99211

The CPT® also has clinical examples in Appendix A to assist.