Is 99211 a valid CPT code?
Asked by: Kailee Bins | Last update: August 6, 2025Score: 4.9/5 (57 votes)
Is CPT code 99211 still valid?
However, CPT 99211 remains an Evaluation & Management service and requires both evaluation AND management elements. Evaluation ─ The record must include documentation of a clinically relevant and necessary exchange of information (historical information and/or physical data).
What are the rules for billing 99211?
Using code 99211 to bill an 'incident to' service
Notes should indicate the degree of the physician's involvement and document the link between the services of the two providers. All 99211 services that don't document or demonstrate that an E/M service was performed and necessary will be denied upon review.
What is the CMS guideline for 99211?
Procedure code 99211 requires a face-to-face encounter. However, when billed as an “incident to” service, the physician's service may be performed by ancillary staff (such as a nurse, or other qualified clinical staff such as a nurse practitioner) and billed as if the physician personally performed the service.
What is the CPT code for nurse office visit?
A: The 99211 E/M visit is a nurse visit and should be used only by a medical assistant or a nurse when performing services such as wound checks, dressing changes or suture removal. CPT code 99211 should never be billed for physician, physician assistant or nurse practitioner services.
Discussion of CPT Code Lookup 99211
Is 99211 a nurse visit code?
Physicians can report 99211, but it is intended to report services rendered by other individuals in the practice, such as a nurse or other staff member. Unlike other office visit E/M codes, a 99211 office visit does not have any specific key-component documentation requirements.
Are there CPT codes for office visits?
Office or Other Outpatient Services CPT® Code range 99202- 99215.
Can 99211 be used for telehealth?
Office visit evaluation and management services (CPT codes 99202-99205, 99211-99215) furnished using audio-video telecommunications technology are reported using the same CPT codes as you would have had the visit been conducted in-person.
What is the CPT code for extended visit?
CPT Code 99417 Update – Prolonged Outpatient Evaluation and Management Services.
Can 99211 be billed by a medical assistant?
That means, you can bill 99211 for a medically necessary, face-to-face established patient service performed by a healthcare professional including a: Medical Assistant (MA) Certified Nurse Assistant (CNA) Licensed Practicing Nurse (LPN)
Can you bill a 99211 for a weight check?
CPT code 99211 may be used to bill for a weight check when the following documentation is present in the nurse's note. The clinical reason for the check is clearly documented in the note. A list of the patient's current medications with his/her compliance level.
What CPT codes are deleted for 2024?
Existing codes 99441-99443 will be deleted. For additional information, refer to Appendices P and T in the CPT 2024 code book. The following E/M codes have been revised in the CPT 2024 code set.
What is the CPT code for no charge office visit?
The 11111 CPT code will register as a no charge visit to your front office staff on the practice management side.
Can you bill 99211 to Medicare?
Services billed to Medicare under CPT code 99211 must be reasonable and necessary for the diagnosis and treatment of an illness or injury. This would include appropriately performed and documented anticoagulation management.
What is the CPT code for filling out paperwork?
Code 99080 is intended to be used when a physician fills out something other than a standard reporting form, such as paperwork related to the Family and Medical Leave Act.
Does 99211 need a modifier?
Do not use modifier 25 on CPT code 99211. Do not use modifier 25 by a physician other than the physician performing the procedure or physician of the same specialty in the same group practice. Do not use modifier 25 when documentation does not support a significant, separately identifiable E/M service.
What is CPT code 99211?
CPT 99211 is an 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 is minimal. Typically, five minutes are spent performing or supervising these services.
What is the CPT code for prolonged visit in 2024?
Code 99417 is used to report prolonged service on the date of an outpatient visit or visit to home/residence.
What is the extended procedure code?
The extended procedure is the combined requested procedure and previous procedure in a 4-digit format. Entering the requested procedure and selecting a previous procedure, creates the extended procedure. If there is no previous procedure, code 00 is added to the requested procedure to create the extended procedure.
How much does a 99211 pay?
CPT Code 99211: Get Paid $23 Per Patient for Nonphysician Services.
What is the CPT code for online visit?
99421: Online digital evaluation and management service, for a patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes. 99422: Online digital evaluation and management service, for a patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes.
Can you charge a copay for a nurse visit?
A patients co-pay may well end up covering most of the visit, which is coded using CPT 99211 . Some practices feel hesitant about asking for a co-pay under these circumstances. Regardless of what the nurse does, if you charge for an office visit, you should, in most cases, bill the patient a co-pay, our sources say.
What is the difference between CPT code 99211 and 99212?
Unlike other office visit E/M codes, such as 99212, which require at least two of three key components (problem-focused history, problem-focused examination, and straightforward medical decision making), the documentation of a 99211 visit does not have any specific key-component requirements.
What is the CPT code for extended office visit?
Prolonged Service codes 99417 and 99418, are used when a physician or other qualified health care professional provides prolonged service involving direct (face-to-face) patient contact or without direct (non-face-to-face) patient contact that is beyond the highest level of service in either the inpatient or outpatient ...
What is the difference between E&M codes and CPT codes?
E&M coding involves use of CPT codes ranging from 99202 to 99499. These represent services by a physician (or other health care professional) in which the provider is either evaluating or managing a patient's health.