Wiki Incident to procedure

[Tonyj]

This is my 2nd posting of this question and I'm hoping that someone could advise as I'm getting different opinions.

Can you bill a procedure performed by the NP under the supervision of the physician as you would an "incident to" providing all supporting documentation is present?

The patient was seen the same day as the procedure by the NP and the physician signed off on the visit and the orders. Incident to criteria met for the E&M but I'm not sure about the procedure, although the physician did attest to the procedure note too.

 

[mitchellde]

Incident to criteria is not met for the E&M if the NP makes a decision for a procedure. To be incident to the NP must follow a documented plan of care from a previous provider encounter. If the plan is amended or a new plan is made by the NP or a new problem discussed,then I this cannot be incident to. Therefore the procedure decided on by the NP cannot be incident to either.

 

[Tonyj]

Incident to criteria is not met for the E&M if the NP makes a decision for a procedure. To be incident to the NP must follow a documented plan of care from a previous provider encounter. If the plan is amended or a new plan is made by the NP or a new problem discussed,then I this cannot be incident to. Therefore the procedure decided on by the NP cannot be incident to either.

I'm going to take your response as a yes, this does meet incident to guidelines due to the fact that the procedure was done as protocol initially set by the physician. I just wasn't sure if "incident to" was inclusive of procedures or only E&M.

Thanks much Debra.