Hi Everyone,
I recently started as a Billing/Coding Specialist for a provider group.
I am noticing that they have a Nurse Practitioner and a Physician's Assistant seeing the same patients on the same day in SNFs and ALFs. They are onboarding more PA's and APNs as we speak. All specialties are family medicine.
They justify this by having the APN see a patient in a SNF or ALF first. The highest level gets coded and a prolonged code gets billed with 2 units (max 4) for the PA. (Therefore combining total time and billing under one provider) Apparently they are seeing the patient for different reasons. For example the APN will see the patient for a UTI, and the PA will see the patient in regards to a fall.
I have questions about the legalities about this. I have googled and googled but cannot find anything in regards to same-day services. I can only find a Physician/PA same day or Physician/APN same day. I have never seen anything about an APN/PA on the same day. I have my RHIT cert and they want me to find anything I can to get these billed out, however I am scared this will flag the group for an audit. Can someone help me out in regards to this?
I recently started as a Billing/Coding Specialist for a provider group.
I am noticing that they have a Nurse Practitioner and a Physician's Assistant seeing the same patients on the same day in SNFs and ALFs. They are onboarding more PA's and APNs as we speak. All specialties are family medicine.
They justify this by having the APN see a patient in a SNF or ALF first. The highest level gets coded and a prolonged code gets billed with 2 units (max 4) for the PA. (Therefore combining total time and billing under one provider) Apparently they are seeing the patient for different reasons. For example the APN will see the patient for a UTI, and the PA will see the patient in regards to a fall.
I have questions about the legalities about this. I have googled and googled but cannot find anything in regards to same-day services. I can only find a Physician/PA same day or Physician/APN same day. I have never seen anything about an APN/PA on the same day. I have my RHIT cert and they want me to find anything I can to get these billed out, however I am scared this will flag the group for an audit. Can someone help me out in regards to this?