I am facing a dilemma here. I coded a 99211 nurse visit for a sore throat. The nurse did a rapid strep test and mentioned in her note that the patient was concerned about decreased fetal movements, so she did a US which showed normal gestation. I was called on an audit because I put a chapter 11 code in front of the pharyngitis code. The auditor's logic is that a nurse isn't qualified to say that the pregnancy is incidental to the sore throat, therefore a chapter 11 code shouldn't be used. I can't find anything that addresses this type of situation. Help!
sore throat-complication or not?
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