Wiki Billing E/M Under the Same NPI

[ReneeKili]

Can a Chiropractor bill an evaluation if the patient was referred from an MD within the same practice under the same NPI?

 

[Cheezum51]

The chiropractor should have their own NPI which would be used to show they provided the E/M service. The group NPI would be used for payment purposes on the c laim form.
If the chiropractor hadn't seen the patient before, and there aren't any other chiros in the practice who have seen the patient in the prior 3 years, the patient would also be a new patient to the chiro so use the appropriate new patient code for the E/M.