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When billing an office visit for say vaccines (medicaid and managed care) I remember at the billing conference someone said the client has to be touched twice in saying this is height and weight separate? Can I bill vaccines, information for the vaccines and Weight as office (99211) or does the nurses have to do Height and weight together as one? Thank you!
I bill 99211 only if the nurses do height weight and education. I know it does not really answer your question, sorry.
Side Note, I am a Registered Medical Assistant and a biller. Per guidelines on the 99211, I cannot bill for a 99211 for when I am in clinic due to the fact that I am not a licensed nurse.Danielle, My nurses are all RN’s I have a standing order from the Dr. for the Health Unit. Do they have to do a Height and Weight together or can they do a Weight with consult to be considered an office visit? What in your opinion constitutes a office visit? Thank you for your help!
Can someone please explain to me the difference between the 99212 and the 99211 when billing for WIC services.
Rebekah, 99211 I bill as I dont have a Dr on site this can be billed with RN’s and standing Dr order and 5 min time with it being an established client. 99212 is 10 min with an established and my understanding has to have a Dr on site… hope this helps..
So I guess we should not be billing hemoglobins for WIC if a nutritionist or WIC Certifier is performing service???? Only a nurse??
Donna, I have always billed WIC this way and got all paid … I’m not sure what Danielle was saying maybe she can explain it again maybe there is something I don’t understand.
We bill office and hgb for WIC with standing orders from a physician and always get paid. I just have gotten the impression that in order to bill that it has to be done by a nurse. Our nutritionist and WIC Certifier (who are not nurses) perform the hgb service so questioning if I should be billing or not?????
What is everyone getting paid for a WIC visit? I’m getting $16.78 from United Health Care and Missouri Care and only $14.87 from Home State. Any ideas?
All office visits – We only bill for code 99211 because we do not have a Dr onsite (we only have RN’s with standing orders). We get different amounts because the payments are based on age. Under 20 (with EP modifier) we bill/get $16.15 (the max you can bill for is $16.78), Over 20 we bill the $16.15 but only get $14.87 (the max allowed for this age group).
Vaccines – We bill for 99211 without a ht/wt – but we only do VFC and charge for the administration of the vaccine ($5 for each component). We have always done this – and have always billed/paid $16.15 (all managed care plans).
I was under the assumption from our billing seminar that the two touch rule (we do ht/wt) were only required to bill OV (99211) on WIC clients.
FYI – every January I check DSS for the most recent Fee Schedule for Medical Services – and if we need to adjust our fees we do.
So when you bill for immunizations, are you billing both the office visit (99211) and for the vaccine administration? For example if you give kindergarten shots, then are you billing 99211 at $16.78 and also 90716 (Varicella) for $5.20, 90707 (MMR) for $15.59 and 90696 (Kinrix) for $20.78, for a total of $58.35? Also, are you billing all of that under the diagnostic code Z23 for immunizations or are you doing Z02.89 for the office visit and Z23 for the immunizations? We’ve never billed an office visit for immunizations, only the vaccine administration fee.
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