Forum - Questions & Answers

Nov 7th, 2014 - yml3768 31 

99211/99212

I work in an ophthalmology clinic and there are times that a patient comes in just to have their pressure checked. They don't really have to see the doctor and the tech is the one that is doing the pressure check. What is the highest level of E/M that can be billed for this service?

I always thought that it was a 99211 as there was no doctor, but there are others that think you can bill a 99212.

Can someone please help clarify.

Thanks!!

Nov 7th, 2014 -

re: 99211/99212

That would be absolutely "incorrect" a tech cannot bill for a E&M visit. E&M levels can only be used by a provider or other qualifired health care professional such as a NP, Pa not by a tech. Also for billing a 99212 you need the qualifing factors such as a problem focused history, problem focused exam and straight forward medical decision makinng. I don't think that checking the pressure has any of these 3 key components and you need at least 2 of the threee to qualify. As for a nurse being allowed to bill a 99211 for a visit w/out a physician being present is also incorrect, there also must be a provider present for a nures to bill for this level of E&M. It may not require the presence of the provider or other qualified health professional, but a provider should be present in the clinic, not neccessarly in the room.

Nov 10th, 2014 - yml3768 31 

re: 99211/99212

Thank you for clearing that up. I have updated our office.

Nov 10th, 2014 -

re: 99211/99212

your welcome:)



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