Wiki FP vs IM and same TIN

[Lisa Bledsoe]

When billing under the same TIN, are Family Practice and Internal Medicine considered "the same" and therefore a patient from FP cannot be coded as new to IM? This is what I believe, but unfortunately cannot find it in writing...

 

[Lisa Bledsoe]

Does anyone have any information on this topic?

 

[LLovett]

Different specialties

They are both recognized specialties so the FP patient that goes to IM is new and vice versa.

http://www.cms.gov/MedicareProvider...TDL-08515MedicarProviderTypetoHCPTaxonomy.pdf

Hope this helps,

Laura, CPC, CPMA, CEMC

 

[Lisa Bledsoe]

Thank you for the link Laura. I assume the physicians must be credentialed with each insurance carrier with the correct taxonomy code for proper recognition and reimbursement? I don't do the credentialing so I'm not sure how this works.
Lisa

 

[cmcgarry]

Lisa, I used to work in the provider area at an insurance company. Most do list the provider's specialties and taxonomy numbers so it shouldn't be a problem. Sometimes, in multi-specialty groups, the insurance co. may have a problem because of all the same tax ID; but most have updated their software to recognize specialties and/or taxonomy codes. You should be OK with most insurance to bill a NP visit with the different specialty. We counted both FP and IM (along with Peds) as primary care, but different specialties.
Hope this helps!