Wiki Article 28??

[cvand1972]

I currently work for a privately owned Cardiology practice. They are thinking of selling to a hospital. They keep saying that the office would qualify under article 28. What is that? And how does the billing work with that? I've been trying to do research and I'm not finding any answers. Can we still at least bill the professional component for the testing (echos, stress echo, nucs, events, holters, vascular services, et) or would that all go away? What about E&M services that our MDs, NPs and PAs provide? Can we bill for those? Does anyone on here do Article 28 billing? Can you share some expectations I could possibly have?

 

[nyyankees]

I currently work for a privately owned Cardiology practice. They are thinking of selling to a hospital. They keep saying that the office would qualify under article 28. What is that? And how does the billing work with that? I've been trying to do research and I'm not finding any answers. Can we still at least bill the professional component for the testing (echos, stress echo, nucs, events, holters, vascular services, et) or would that all go away? What about E&M services that our MDs, NPs and PAs provide? Can we bill for those? Does anyone on here do Article 28 billing? Can you share some expectations I could possibly have?

You would bill BOTH the professional and technical components. You would bill a physician E&M and a facility E&M for a patient visit. You would base the facility E&M not on history, exam, etc but on resources used by the office. If MA takes vitals and walks patient to room we bill 99212TC. Your procedures, i.e. ekgs are billed 93010 and 93005 rather than just the global 93000. You would bill echos 93006-26 and 93006-TC. Your POS is 22 not 11. good luck finding any quality info on article 28 as I could not.

 

[cvand1972]

Oh boy....Thank You!!

 

[michelek54]

You would bill BOTH the professional and technical components. You would bill a physician E&M and a facility E&M for a patient visit. You would base the facility E&M not on history, exam, etc but on resources used by the office. If MA takes vitals and walks patient to room we bill 99212TC. Your procedures, i.e. ekgs are billed 93010 and 93005 rather than just the global 93000. You would bill echos 93006-26 and 93006-TC. Your POS is 22 not 11. good luck finding any quality info on article 28 as I could not.[/QUOTE

Can both the physician and the facility bill the E & M code? Does the facility need to use a modifier for there E & M? Is it for the physician 99212 and for the facility 99212/TC?