Wiki My liability as a coder, biller in the office

[AMANDACARLA]

In my practice the doctor went on vacation for a week an the nurse practitioner saw new patients and established treatment even to medicare patients and when i told her she that was wrong, she told me "the doctor told her to see all patients, we will do a write off later". What is my responsibility as a coder in front of this problem?. Please give me your advise.

 

[LLovett]

Are NPs not allowed to see patients independently in your state? Or is she only credendialed as incident to your doctor?

In Michigan, as long as they are credentialed and the doctor says they are able to provide the service we can bill for those services under the NP.

I don't think you are liable for anything in this case unless you would knowingly bill these as incident to in order to get paid, which would be fraudulent billing.

Just my opinion,

Laura, CPC

 

[FTessaBartels]

Bill under NP's name/NPI

If the NP is credentialed with Medicare, and this is in his/her scope of practice, then you code the appropriate level of service and bill out under the NP's name/NPI.

F Tessa Bartels, CPC, CEMC

 

[RebeccaWoodward*]

As usual, I agree with Laura and Tessa.

Effective for services rendered after January 1, 1998, any individual who is participating under the Medicare program as a nurse practitioner (NP) for the first time ever, may have his or her professional services covered if he or she meets the qualifications listed below, and he or she is legally authorized to furnish NP services in the State where the services are performed. NPs who were issued billing provider numbers prior to January 1, 1998, may continue to furnish services under the NP benefit.

(See qualifications)

Assuming she/he is qualified within your state and has her/his own NPI number, file under her/his name and NPI number

Section...200

http://www.cms.hhs.gov/manuals/Downloads/bp102c15.pdf