Medicare Compliance & Reimbursement

Hint: Just because your doctor visits the ICU doesn't mean he can report critical care. Most medical practices report outpatient E/M codes (99201-99215) every day, but some Part B providers are still falling victim to several of the most common E/M myths. Button up your coding processes by dispelling these three commonly held misunderstandings. Myth 1: When reporting 99211 "incident to" a physician, you should bill it under the name of the physician on record for that patient. Reality: When a service such as a nurse visit (99211, Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of the physician) is billed incident to the physician, make sure you file the claim under the supervising physician's name. The OIG recently found that many practices are billing incident to services under a physician's name who was not on the premises [...]