Wiki billing as prolonged time for 2 providers, same speciality, same DOS

[LauraNewYork]

We periodically have situations were two Nurse Practitioners will see the same oncology patient, same DOS for 2 different reasons. Can we can combine the NP's time together and use prolonged time as appropriate?

Example:
First NP sees established patient for chemo teach and documents 50 minutes; second NP sees same pt for genetic counseling and documents 50 minutes. Both are working "incident to" a medical oncologist at the same practice. Total time is 100 minutes. Can this time be billed out as one bill using 99215 with a prolonged time code (99417 or G2212 with multiple units as appropriate). There would be 2 separate notes in the chart.

 

[Cheezum51]

No, each NP's time stand by itself. Even if both of them see the pt simultaneously, only the time for one of them counts.

Tom Cheezum, OD, CPC, COPC

 

[SharonCollachi]

No, each NP's time stand by itself. Even if both of them see the pt simultaneously, only the time for one of them counts.

Tom Cheezum, OD, CPC, COPC

Are you saying to bill two separate office visits under the same provider name for the same dos? These are incident-to, so they are billed under the provider name. And they are not seeing the patient at the same time (if I understand the OP correctly).

 

[LauraNewYork]

The NPs are not seeing the patient at the same time. Example: patient with new breast cancer and strong family history of cancer has a Chemo teach appointment at 1pm and a Genetic counseling appointment at 2pm on the same day. Both NPs are working incident-to the patient's attending oncologist. (We have 14 oncologist and around 25 NPs. Some of the NPs have focused their energies into genetic counseling, supportive oncology, survivorship, etc.)

 

[SharonCollachi]

The NPs are not seeing the patient at the same time. Example: patient with new breast cancer and strong family history of cancer has a Chemo teach appointment at 1pm and a Genetic counseling appointment at 2pm on the same day. Both NPs are working incident-to the patient's attending oncologist. (We have 14 oncologist and around 25 NPs. Some of the NPs have focused their energies into genetic counseling, supportive oncology, survivorship, etc.)

I'm seeing that the time should be combined, as if it were done by one person, in this situation.

 

[csperoni]

In this scenario, I would combine the time.
That being said, I would also confirm incident-to was met.

 

[LauraNewYork]

Thank you everyone for your input. The docs are all careful to document in their notes so incident-to can occur.
I hoped we could combine the "incident-to" appointments, but wanted to hear what others thought. This makes scheduling appointments a lot easier for the patient and we (the practice) are able to recoup our practitioners time.