Physician Billing and Coding for Hospital Visits

[lgarcia96]

Hello,
The Doctor's that I work for go visit patients in the hospital with the help of an NP.. To bill this shared/split billing, is it enough for the Dr to just sign the note that the NP created or does the Dr also need to add their attestment to get credit? Any insight is appreciated, TIA

 

[thomas7331]

Hello,
The Doctor's that I work for go visit patients in the hospital with the help of an NP.. To bill this shared/split billing, is it enough for the Dr to just sign the note that the NP created or does the Dr also need to add their attestment to get credit? Any insight is appreciated, TIA

CMS requires that the provider who is billing for the split/shared E&M service must perform a 'substantive portion' of the services, which they've clarified this year to mean that the provider has either spent more than half of the total E&M time, or has completely performed one of the key elements of history, exam or MDM for the level which is being billed.

If the MD is only signing the note or is only adding their attestation, then the MD cannot bill for the E&M service and it must be billed under the NP's credentials.

 

[lgarcia96]

CMS requires that the provider who is billing for the split/shared E&M service must perform a 'substantive portion' of the services, which they've clarified this year to mean that the provider has either spent more than half of the total E&M time, or has completely performed one of the key elements of history, exam or MDM for the level which is being billed.

If the MD is only signing the note or is only adding their attestation, then the MD cannot bill for the E&M service and it must be billed under the NP's credentials.

Thank you very much Thomas for this info!
https://hsgadvisors.com/articles/the-2022-cms-split-shared-visit-rules-and-the-anticipated-impacts/ - do you agree with this site for a detailed explanation for my providers?

 

[thomas7331]

Thank you very much Thomas for this info!
https://hsgadvisors.com/articles/the-2022-cms-split-shared-visit-rules-and-the-anticipated-impacts/ - do you agree with this site for a detailed explanation for my providers?

I think the article you've linked is a good summary of the new requirements. I usually prefer to use original sources rather than articles that paraphrase or interpret them, but I don't think that the Medicare manuals have been updated yet for 2022 and the language in the final rule is not presented succinctly, so sharing this article with your physician is a good way to go for now.

 

[kmuerth]

I am adding a question to this. If the physician only signs or adds the attestation and we bill under the PA's npi number, do we still append the modifier -FS to the E/M?

 

[csperoni]

I answered this in another thread where you posted the same question.
If the physician only signed the note, but did not provide part of the service, it is not a split/shared visit and -FS would not apply.