Gastroenterology Coding Alert

Physician NPI means you're paid in full on claim. Coders who are not on the lookout for incident-to billing opportunities are costing their practices deserved reimbursement. Impact: If a qualified nonphysician practitioner (NPP) provides a service to a Medicare patient incident-to the physician, then you can report the visit under the gastroenterologist's national provider identifier (NPI), netting you 100 percent pay for the service; when you bill under the NPP's NPI, you'll receive 85 percent of the full rate. Use this incident-to coding know-how and nail every opportunity to bill under the gastroenterologist's NPI. Find Supervision, POC Evidence Before Billing Before you bill a service incident-to your gastroenterologist, check for two things: 1. In order to code an encounter incident-to, Medicarerequires that a qualified NPP work under "direct supervision" of a gastroenterologist, confirms Melissa Briggs, CPC, who works in coding and compliance at Cotton O'Neil Clinic in Topeka, Kan. The [...]