Wiki Incident To

KaylaRieken

True Blue
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Waukee, IA
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If a patient has recurrent UTIs and the PA sees the patient under the supervision of the doctor but prescribes an antibiotic for a UTI, can this be billed under the doctor? The patient is prescribed antibiotics all the time for her recurring UTI.
 
IF the physician is in the building, and has recently treated the patient for UTI, I would consider this incident to. If the last time the provider saw this patient for a UTI was a year ago, I would not call this incident to.
For example: scenario 1 - pt seen 08/25/19 - UTI - doc told the pt to drink lots of cranberry juice and water, hoping to avoid prescribing antibiotics again and patient returns 09/10/19 with no improvement of symptoms. I call this an existing problem with a plan of care and incident to.
Scenario 2 - pt seen 06/05/2018 with UTI - doc provides abx rx and advises urination following intercourse. Symptoms resolve. Pt returns 09/10/19 with same symptoms. I would call this a new problem and NOT incident to.

Here's MY PERSONAL rule about incident to: If I cannot easily/quickly find a definitive YES, then I bill under the PA. The $10-$20 reimbursement difference is not worth 30 minutes of my time or possible insurance audits if being used incorrectly. And that's my 2 cents.
 
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