Questions continue to be raised about the appropriate billing of code 99211. Can this level of service be reported by a physician? Would it be appropriate to report a nurse visit when, for example, the nurse administers vaccines or an antibiotic, performs a strep test, obtains blood, reads a purified protein derivative (PPD), or performs a weight check?

The Current Procedural Terminology (CPT®) descriptor for code 99211 states, “Office or other outpatient visit for the evaluation and management [E/M] of an established patient, that may not require the presence of a physician. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services.” The key to reporting this service? It must be medically necessary and require a face-to-face E/M service with supporting medical record documentation.

A physician typically does not report this level of E/M. Usually when the visit re-quires a face-to-face with...

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