Our very own @KarenCorso wrote up a nice little cheat sheet we wanted to share. Here’s the long and the short of it…you can make some money without changing your clinical workflow if you do this the right way!
The top 10 Tips/Requirements for billing without an MD present…
PREAMBLE:
Sure, you can monetize your non-MD time. That said, don’t go celebrating without reading the fine print or you might end up hosting America’s Got Talent after an audit goes south.
Without Further ado…your Top 10 Tips/Requirements for billing 99211
1) Office or other outpatient visit for the evaluation and management of an established patient, that may not require the direct presence of a physician. The physician must be in the office suite or in the general vicinity. Physician must be “interruptible” if necessary. Typically, 5 minutes are spent performing these services. (Ex: dressing changes, suture removal)
2) Can be performed by a CMA, RN or LPN under the license of an MD, NP or PA.
3) Must be performed by the staff of the practice.
4) Can not be within the global period unless the service was done elsewhere. Ex: (sutures were put in at a hospital or urgent care center) and the patient comes to the office for suture removal by the nurse, LPN or CMA)
5) Must be incident-to-physician-provided service. Check out our other article if you’re unclear.
6) Place of service 11.
7) Some payers will not pay 99211 for any service not performed by the MD, NP, or PA (Should be in physicians contract)…yes…yet again…the only rule in billing is there’s an exception to every rule.
8) Diagnosis must be assigned by MD, NP or PA not the nurse or staff.
9) Co-pay will be taken at the time of service.
10) EOB will have MD’s name as provider of service…because we billed incident-to…remember?
What will this earn you? Think $20-35 a visit depending on your contracts…now there’s a reason to celebrate. Call your Auctus biller to get the celebration started! 🎉
