Code 99211 may be reported for nurse visits if the service is what?

Code 99211 may be reported for nurse visits if the service is what?

• A. It should never be reported
• B. It is appropriate only when a physician is present
• C. It may be reported if the service is medically necessary and properly documented
• D. It is always reported for nurse-only visits

Answer: (C)

99211 is a minimal established-patient E/M encounter that can be billed when a nurse (or other qualified professional) provides the service without the physician present, but only if the service is medically necessary and properly documented. The key idea is that nurse-only care can be billed when it contributes to patient management, and the documentation clearly supports why the visit was needed, what nursing tasks were performed (for example, vitals, wound care, dressing changes, medication administration), the time involved if applicable, and the plan or follow-up instructions. This code isn’t used for every nurse visit, and it isn’t required to have a physician present, but it must meet medical necessity with thorough documentation.

99211 is a minimal established-patient E/M encounter that can be billed when a nurse (or other qualified professional) provides the service without the physician present, but only if the service is medically necessary and properly documented. The key idea is that nurse-only care can be billed when it contributes to patient management, and the documentation clearly supports why the visit was needed, what nursing tasks were performed (for example, vitals, wound care, dressing changes, medication administration), the time involved if applicable, and the plan or follow-up instructions. This code isn’t used for every nurse visit, and it isn’t required to have a physician present, but it must meet medical necessity with thorough documentation.