Drug Administration Services and E/M Visits Billed on Same Day of Service
CPT code 99211 cannot be paid if it is billed with a drug administration service such as a chemotherapy or non-chemotherapy drug infusion code, or therapeutic or diagnostic injection code. Therefore, when a medically necessary, significant and separately identifiable E/M service (which meets a higher complexity level than CPT code 99211) is performed in addition to a drug administration, the appropriate E/M CPT code should be reported with the 25 modifier. Documentation should support the level of E/M service
billed. For an E/M service provided on the same day, a different diagnosis is not
required.
Office/Outpatient or Emergency Department Visit on Day of Admission to Nursing Facility
A physician may not be paid for an emergency department visit or an office visit and a comprehensive nursing facility assessment on the same day. The E/M services on the same date provided in sites other than the nursing facility are bundled into the initial nursing facility care code when performed on the same date as the nursing facility admission by the same physician.
CPT code 99211 cannot be paid if it is billed with a drug administration service such as a chemotherapy or non-chemotherapy drug infusion code, or therapeutic or diagnostic injection code. Therefore, when a medically necessary, significant and separately identifiable E/M service (which meets a higher complexity level than CPT code 99211) is performed in addition to a drug administration, the appropriate E/M CPT code should be reported with the 25 modifier. Documentation should support the level of E/M service
billed. For an E/M service provided on the same day, a different diagnosis is not
required.
Office/Outpatient or Emergency Department Visit on Day of Admission to Nursing Facility
A physician may not be paid for an emergency department visit or an office visit and a comprehensive nursing facility assessment on the same day. The E/M services on the same date provided in sites other than the nursing facility are bundled into the initial nursing facility care code when performed on the same date as the nursing facility admission by the same physician.
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