Otolaryngology Coding Alert

Question: One of our nonphysician practitioners saw a patient during a follow-up visit -- what is required in order for us to report these services to Medicare as incident to the ENT? Florida Subscriber Answer: To qualify for incident to, the physician must have seen the Medicare patient during a prior visit and established a clear plan of care. If the nonphysician practitioner (NPP) is treating a new problem for the patient, or if the ENT has not established a care plan for the patient, then you cannot report the visit incident to. Important: When meeting the requirements for a follow-up to an established plan of care, if the ENT does not directly supervise the NPP, the incident-to rules do not apply. Direct supervision means a supervising physician must be immediately available in the office suite. The supervising physician, however, does not necessarily need to be the same physician that established [...]