AAPC - Back to school
Results 1 to 2 of 2

Thread: NPP and consultation help

  1. #1

    Default NPP and consultation help

    AAPC: Back to School
    A consultation can not be a split/shared visit, but our physicians want to use our PA's for on call at the hospital. We are having alot of debate as to whether the PA's can perform any part of the consultation. Can a PA do any part of the consultation;like taking the HPI or the ROS, then the physician come in and do the exam and MDM? Then the pt would act as the scribe, making it clear the physician did the exam and MDM. Just wondering what others think and are doing. Thanks.

  2. #2
    Join Date
    Apr 2007
    North Carolina


    "Incident to" does not apply in the hospital setting.

    In the hospital setting, the consulting physician or qualified NPP shall use the appropriate Initial Inpatient Consultation codes (99251 – 99255) for the initial consultation service.

    In the office or other outpatient setting, the consulting physician or qualified NPP shall use the appropriate Office or Other Outpatient Consultation (new or established patient) codes (99241 – 99245) for the initial consultation service.



    When a qualified nonphysician practitioner (NPP) and a physician each provide a portion of the consultation services, the split/shared services may not be billed as a consultation, according to the Medicare Claims Processing Manual. If an NPP provides the bulk of the service, the NPP should report the appropriate code under his or her own provider number even if the physician documents examining the patient and reviewing the management plan.
    Last edited by RebeccaWoodward*; 01-21-2009 at 01:47 PM.

Similar Threads

  1. billing for NPP'S
    By kimmyjwright in forum Cardiology
    Replies: 2
    Last Post: 12-08-2014, 01:47 PM
  2. NPP billing
    By laharp4 in forum Billing/Reimbursement
    Replies: 2
    Last Post: 11-30-2011, 11:17 AM
  3. Npp
    By krssy70 in forum E/M
    Replies: 5
    Last Post: 02-25-2010, 08:01 AM
  4. Npp
    By amb1974 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 08-19-2009, 06:15 AM
  5. Npp
    By jemill in forum E/M
    Replies: 1
    Last Post: 09-17-2008, 12:05 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.