Wiki Incident-to and med changes

[abranch13]

Is it correct if a NP is seeing a pt for a follow up visit and end up changing the pts med doses, this cannot be billed as incident-to? My office sees mostly diabetic pts, they see the physician who establishes the plan of care, and often times come in for follow up with an NP.....if the NP has to change the pts insulin dosage at the follow up, does this make the visit no longer incident-to? They are often times consulting with the physician when making the dosage change, but the NP is the one seeing the patient.

Any thoughts are appreciated!

Thanks

 

[mitchellde]

This cannot be incident to even if the NP consults with the provider. The provider would need to see the payient face to face and write the encounter note to charge a med change using the provider NPI.

 

[Saedron]

Debra,

Love all your informative posts!

Why can't this be billed incident to? If the care plan is established, and the visit is a follow-up of an already established problem, I don't see why this can't be incident to.

I see this quite often with patients for anti-coagulation follow-up visits. So I want to be sure my practices are doing this correctly.

Thanks for any clarification!

 

[mitchellde]

When the medication doses are changed then this is a new plan of care. Now it is the NP plan of care not the original physicians written plan of care.