Question Fellows and NPPs

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In the hospital setting, if the NPP sees a patient, and then a Fellow sees that same patient and adds an attestation to the NPPs daily progress note, can I still bill under the NPP (since I can't bill under the Fellow)?
 

kathrynw

Networker
Administrator
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93
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Grantsville, UT
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Hello,

I found the following, hopefully it will help.

According to CMS:
An Intern or Resident is an individual who participates in an approved Graduate Medical Education (GME) Program or a physician who is not in an approved GME Program but who is authorized to practice only in a hospital setting (e.g., has a temporary or restricted license or is an unlicensed graduate of a foreign medical school). Also included in this definition are interns, residents, and fellows in GME Programs recognized as approved for purposes of direct GME and IME payments made by Fiscal Inter-mediaries or A/B Medicare Administrative Contractors. Receiving a staff or faculty appointment, participating in a fellowship, or whether a hospital includes the physician in its full-time equivalency count of residents does not by itself alter the status of “resident.”

For the detailed CMS guidelines see Chapter 12, Section 100, of the Medicare Claims Processing Manual (Pub. 100-4) at http://www.cms.hhs.gov/Manualson the Centers for Medicare & Medicaid Services (CMS) website.
 
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239
Location
Selden
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My understanding of NPP and fellows (or residents) is that the NPP cannot act as a "teaching physician" so you may bill the NPP services based only on the NPP documentation. For example, NPP saw inpatient in the morning - no new complaints, improving, etc and the coding for that would be 99232; if the fellow sees patient later in the day and has a new complaint of abdominal pain and orders a CT, you cannot combine the notes/medical decision making and come up with 99233 to bill that under your NPP. You would code and bill based only on the services your NPP performed and documented.
 
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