NP & Attending saw patient in critical care

[myirskc]

If a NP was the first to see a patient as critical care on a given day, meets the 30 minutes, and the attending physician sees patient later on the same day and also meets critical care with 30 minutes, Is there a regulation that states we must bill under the 1st person (the NPP) for the critical care to medicare?

 

[FTessaBartels]

Our policy

I do not know if there is a Medicare ruling on this. But I do know that our practice policy is that if two providers (same specialty, same practice) see the patient on the same day, all the documentation is considered as ONE E/M visit, and we always bill under the first person who saw the patient.

The only exception is when Provider # 1 sees a patient who is stable earlier in the day; but the patient "crashes" later and Provider # 2 provides critical care. Then we code the E/M for Provider # 1; and critical care for Provider # 2.

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[myirskc]

Thank you, it does help and seems like the easiest way to solve this problem. However we can't spilt/share critical care with the NP and attending and if we bill under the NP we olny get reimbursted 85% with some ins carriers. This is why I was trying so hard to see if anyway heard that we must bill under the 1st person who saw the patient, or can we pick and choose.