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The first question attempted to broadly elicit ways to reduce the burden associated with the documentation of patient E&M visits. The second question was designed to gain input from attendees on approaches that other payers take to both payment and documentation regarding E&M visits.
A National Organization of Rheumatology Managers (NORM) board member received this question from a member of the organization, “This is a query for anyone who is familiar with the billing and coding of infusions.
We frequently receive questions regarding the infamous “nurse visit,” and what documentation Medicare or other payers expect to see when billing the Current Procedural Terminology code 99211. So, what are the exact medical documentations that would support billing the evaluation and management (E&M) code 99211 alone or with other billable services?
You may know by now that the Centers for Medicare & Medicaid Services created Healthcare Common Procedure Coding System (HCPCS) code Q5102 to be used when reporting “Injection, infliximab, biosimilar, 10 mg.” The October 2017 HCPCS update included a new modifier, ZC Merck/Samsung Bioepis, to be used with HCPCS code Q5102.
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