Medicare does not recognize the New CPT codes for anti-coagulation management in 2007. If a nurse is performing a Prothrombin time test, is it appropriate to also bill an E&M using 99211 to Medicare?
You should not routinely bill a Prothrombin blood draw (85610) with an Evaluation and Management service. WPS Medicare Part B published an article in the June 2006Communiquedescribing situations when this would be acceptable. Keep in mind that documentation on the INR flow sheet alone is not sufficient for billing 99211. There must be a new symptom or a reason clearly identified and documented to support billing a 99211. In addition, Medicare “incident-to” guidelines must be met. This would include the direct supervision component, requiring the physician to be available in the office suite.Clickhereto learn more.Our practice is considering contracting with a pharmacist (Pharm D) to assist in our anti-coagulation clinic and to assist in medication management plans for chronic pain management. Can Pharm Ds bill under the “incident-to” guidelines?Pharm Ds may provide services under the Medicare “incident-to” guidelines when all appropriate incident-to criteria is met. Pharmacists are not
You should not routinely bill a Prothrombin blood draw (85610) with an Evaluation and Management service. WPS Medicare Part B published an article in the June 2006 Communique describing situations when this would be acceptable. Keep in mind that documentation on the INR flow sheet alone is not sufficient for billing 99211. There must be a new symptom or a reason clearly identified and documented to support billing a 99211. In addition, Medicare “incident-to” guidelines must be met. This would include the direct supervision component, requiring the physician to be available in the office suite. Click here to learn more. Our practice is considering contracting with a pharmacist (Pharm D) to assist in our anti-coagulation clinic and to assist in medication management plans for chronic pain management. Can Pharm Ds bill under the “incident-to” guidelines? Pharm Ds may provide services under the Medicare “incident-to” guidelines when all appropriate incident-to criteria is met. Pharmacists
Related Questions
- Medicare does not recognize the New CPT codes for anti-coagulation management in 2007. If a nurse is performing a Prothrombin time test, is it appropriate to also bill an E&M using 99211 to Medicare?
- What CPT code should be used for symptom management when the clinician is not a doctor or psychiatric nurse practitioner (NPP)?
- Do I have to pay social security or medicare taxes while on CPT?
