Wiki APNP ?

[RebeccaB]

Hi everyone,
Our group now has an APNP which is new for the practice..I have never billed for APNP services before..any suggestions on a good resource to learn ??

here is an example of a hospital visit...time spent assessing patient, reviewing chart and collaborating with RN staff was 50 minutes.
Patient's condition was discussed with Dr S, collaborating physician
Signed: APNP

Agree with above
Dr S

This would be billed under the APNP..?? Any help in understanding this new area much appreciated
Thanks
Rebecca

 

[csperoni]

In general, the CPT & ICD10 coding for NPP (PAs & NP) are the same as for your physicians.
You should research incident to (for office services) and split/shared visits (for hospital services). These billing rules allow your NP services to be billed under your physician in very specific circumstances. Please keep in mind these are MEDICARE rules. Some private carriers follow them, some do not. You must confirm with each of your carriers.
Here are some articles/links:
https://med.noridianmedicare.com/web/jeb/topics/incident-to-services
https://www.palmettogba.com/palmett...y Asked Questions~Incident to~AK3F6A4053?open
Certainly the Medicare manuals are the official resource, but not easy to read. Both links above include what chapters/sections of the Medicare manual the info was taken from.

In your example above for inpatient services, you must bill under the NP. For hospital setting, the physician must also provide face-to-face services to bill under physician, not just sign off. If that same note was office services, you could bill under the physician IF the physician was physically present in the building AND an established patient with an established problem with a plan of care.

 

[RebeccaB]

Thank you so much for the info..when reading all of the stuff on a subject you're not familiar with it becomes very easy to over think things

 

[SharonCollachi]

Incident-to is in office; shared visits are in hospital. AAPC has its own article here. (Edited to say that I misread that; it is an AAFP article, not AAPC). So if the physician does not see the patient in the hospital face-to-face, the NPP must bill on their own. Some providers reimburse NPP services at a reduced rate.