![]() Suture removal following placement by a different physician/physician group. ![]() Discussion with patient in-person following laboratory tests results that indicate the need to adjust medications or repeat order of tests.Refilling medication for a patient whose prescription has run out however, the patient must be present in the office suite and physically seen by the provider.A blood pressure evaluation for an established patient whose physician requested a follow-up visit to check blood pressure.A follow-up visit is scheduled for a weight check. The patient recently placed on a new medication that causes weight gain.The provider-patient encounter must be face-to-face, not via telephone.The service must be separated from other services performed on the same day.The patient must be established, not new.The service must be for evaluation and management (E&M).According to the Procedure Code Book, 99211 is intended for “an office or other outpatient visits for the evaluation and management of an established patient that may not require the presence of a physician.” The key points to remember regarding 99211 are: ![]() All E&M office visits follow the member’s office visit benefit therefore, if another Procedure code more accurately describes the service, that code should be reported instead of 99211.īecause the appropriate use of Procedure code 99211 is often confusing, we offer the following guidelines. For example, if the patient receives only a blood pressure check or has blood drawn, 99211 would not be appropriate.
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