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msoini

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Essexville, MI
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If a nurse practioner sees the patient for the wellness and then the doctor follows up at the end of the wellness, is it still appropriate to bill under the doctor because of incident to. Both the doctor and NP have documentation in the wellness note. The NP got flagged saying it should have been billed under her not the doctor. The coder that audited it said due to split shared rules. That did not make sense to me because I thought those rules applied only to in pt and not an office setting. Any thoughts?
 
Hi there, I can't tell whether the encounter meets the incident-to criteria but you're correct that split/shared rules would not apply. Medicare's new split or shared rules apply to facility visits. The CPT guidelines apply to office E/M visits (99202-99205 and 99212-99215).
 
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