Urology Coding Alert

Don't forget you can still get 85 percent reimbursement if you don't meet incident-to criteria.As practices try to battle falling income, many are striving to maximize the urologists' time and supplement services using non-physician practitioners (NPPs). If you know the incident-to billing rules, you will ensure a 100 percent reimbursement for those services. But if you're not careful, you'll set yourself up for denials and potentially fraud accusations. Follow three expert tips to ensure your Medicare incident-to billing brings in extra reimbursement while still staying legal and compliant.Watch Out for New Patients and New ProblemsYou can bill "incident to" only when the NPP treats an established Medicare patient who has been seen initially by the urologist who has established a particular plan of care (POC) for this individual patient. The POC must also be the reason for the encounter. If the NPP addresses a new problem during the visit or [...]