Wiki Help with E/M Assisted Living Codes 99324-99328

Create Wiki
G

ginacoder3185

New
Messages
6
Location
Reeds Spring, MO
Best answers
0
Hello,

Anyone know whether a nurse practitioner or a physician assistant can use this code set at an assisted living facility for new patients or is this code set for MDs only? We also use codes 99304-99310 and NPs and PAs can only use established codes for new/established patients. I wonder if this is applicable to an assisted living facility as well? Thank you for your time!

Regina
 
There are no codes that are for MDs only - you may be confusing the 'incident to' rules with coding rules.

The PA or NP can and should use this code if that is the service that they performed. Services performed in a facility may not be billed as 'incident to', so nothing that a PA or NP does in the facility should ever be billed under the MD's credentials. There is no rule that says a PA or NP may not see a new patient, and if the patient is new to the practice and specialty, then it should be billed with a new patient code.
 
Ok I replied to the other thread too. We were told NPs and PAs only use established patient code set for initial and established visits in a skilled nursing facility.

If you don't mind, what is the incident to rules so I can look this up for reference?

Thank you!
 
There are many articles about 'incident to' available if you do a search - here's a good one here on the AAPC web site: https://www.aapc.com/blog/44912-seven-incident-to-billing-requirements/

However, 'incident to' billing is only allowed for services performed in the physician's office. With the exception of a split/shared visit, where the MD and the mid-level provider both evaluate the patient on the same day, anything done in the facility must be billed under the provider who performed the service.
 
You must log in or register to reply here.
Top