Otolaryngology Coding Alert

Question: I know I cannot bill services incident-to in the hospital setting. Is there a way to capture the time a nonphysician practitioner (NPP) spent with a patient? Tennessee Subscriber Answer: Yes, you can bill split/shared E/M services in the hospital setting. The catch: The otolaryngologist must provide a substantive portion of the service. This definition comes from the Medicare carrier First Coast: A split/shared visit is a medically necessary encounter with a patient where the physician and a qualified nonphysician practitioner (NPP) each performs a substantive portion of the E/M visit, faceto- face with the same patient on the same date of service. A substantive portion of an E/M visit involves all or some portion of the history, examination, and medical decision making components of the E/M service. Simply signing off on the NPP's note does not meet the criteria for a split/ shared visit. The physician and NPP [...]