provider types

sherriev

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Local Chapter Officer
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Owensboro, KY
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In the BH office that I code for, there are LPCCs, LCSWs, APRNs, and MDs(Psychiatrists). The office belongs to a hospital who has multiple offices. These offices bill under the same tax ID number. I am fairly new in healthcare and recently learned about different taxonomy group codes. I learned that our APRNs throughout the same organization cannot bill new patient e/m codes if another APRN in the organization has seen the patient. My question is if the patient has been seen by a Psychiatrist and then by an APRN in the same clinic, would the APRN be able to bill a new patient level e/m code?

Thank you!
 
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Great question...

I used to work in a big hospital system such as the one you mentioned. If the patient was seen within the same specialty or clinic they cannot bill for a NEW E/M code. The patient would be considered a return patient. In this case, the level of provider doesn't make a difference.
 

sherriev

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Local Chapter Officer
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24
Location
Owensboro, KY
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Thank you! That was my original thought, but I was doubting myself on this one. It is good to confirm with someone else.
 
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