Wiki Incident to question- please assist

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micki127

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Hi,

If a Nurse Practitioner is seeing a patient as a follow up visit and following the treatment plan of the MD from the previous office visit. We bill that as incident to. My question is if the NP has added a new diagnosis that was not included in the previous office note by the MD but is on a sleep study report that the MD has created after the MD's office visit but before the NP has seen the patient. Can that be billed incident to? Or must this diagnosis be originally on the office note?

Any advice would be greatly appreciated.

Thank you in advance.
Micki
 
'Incident to' requirements are met if the NP is executing an existing plan of care established by the MD. I think the fact that he or she 'added a new diagnosis' that wasn't on a previous office note is not really relevant - the question that would determine if the service is 'incident to' is who made the diagnosis and who created the treatment plan for that problem. So if the MD made the diagnosis as part of the sleep study and wrote the orders for that diagnosis, and the NP is just carrying out that plan, and assuming to that the supervision requirements are met, then it would still qualify as an 'incident to' service. If the NP is developing their own plan for the patient for that diagnosis, then it would not.
 
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