Incident To 1500 form

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When you have a PA see a patient in an office setting with a supervising Dr for the day, who was not the Initiating Dr. how should the 1500 form be filled out? From what we can understand, Line 17 is Initiating Dr."Incident To", #31 is Supervising Dr and J is the PA #. Is this correct?
 

btadlock1

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When you have a PA see a patient in an office setting with a supervising Dr for the day, who was not the Initiating Dr. how should the 1500 form be filled out? From what we can understand, Line 17 is Initiating Dr."Incident To", #31 is Supervising Dr and J is the PA #. Is this correct?
Was it for a new condition, or a new patient? If so, you can't bill Incident-to. The MD has to have seen the patient for the condition prior to the visit, and initiated a treatmetn plan. Also, he must have been present in the office suite at the time of service, to bill incident-to.

It sounds like you need to bill under the PA's #'s - the PA's individual NPI goes in box 24J, and the group NPI goes in 33A. Box 31 (I think that's the signature line, right?) gets the PA's name.
(See Requirements here: http://www.trailblazerhealth.com/Publications/Training Manual/incident_to.pdf)

If you are able to bill incident-to, then you'd put the MD's individual NPI in box 24J, and his name in 31. Everything else should be the same. Hope that helps! ;)
 
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Thanks for your help. Also, could you tell me if the Incident To Dr. is considered the Initiating Treatment Dr. or the Supervising Dr. in the office that day. We are a single specialty group. We read in Medicare manual the Initiating treatment Dr would be in #17, the PA incident to Follow up would go into 24 J and the Suite Dr for the day would be in box #31. So very confusing. Thanks for all of you help.
 

btadlock1

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Thanks for your help. Also, could you tell me if the Incident To Dr. is considered the Initiating Treatment Dr. or the Supervising Dr. in the office that day. We are a single specialty group. We read in Medicare manual the Initiating treatment Dr would be in #17, the PA incident to Follow up would go into 24 J and the Suite Dr for the day would be in box #31. So very confusing. Thanks for all of you help.
If you're billing incident-to, the PA's info doesn't go on the claim, period. Just the supervising MD's NPI's in 24J & group in 33A, and his name in 31 - the referring (eg, 'initiating') physician's info should be listed in 17. I can't stress this enough, though - this cannot be a new condition. Your documentation should reflect that the MD has already addressed the problem, and established a treatment plan. If you're billing for an acute condition, it may not meet the requirements for incident-to.
 
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'Incident to' follow-up

As we are progressing with this information, more scenarios are coming to light. For example, the doctor has initiated treatment of someone with HIV. In the course of 'incident to' follow-up the PA notices a new problem, i.e. skin lesion, that is related to the HIV. Is this still incident to? Another scenario is the patient is being treated for HIV and comes in with a sinus infection, is this still incident to because the treatment hasn't changed but the PA has prescribed antibiotics?
 
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