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It has been my understanding that as long as a physician ordered something for a patient and there is documentation in the chart of that, ie shot of B12 or methotrexate for a diagnosed condition that is being followed by the MD, that it is perfectly acceptable for the nurse to give the injection and charge 99211 with the injection J code even if the MD is not present

HCG is actually used as a tumor marker in some cancers because certain tumors produce it