Wow! I think there are several questions to answer in your post.
1) If the NP/PA is acting as a scribe and specifiy acts in this capacity and documents that he/she is acting only as a scribe and is documenting everything done by the physician and the physician is doing everything that supports the service billed, then that is not shared billing or incident to. In this case it is a physician service since the physician is doing all of the work.
2) Keep in mind that there is no shared billing for consultations and that shared billing is not applicable in an office setting.
3) New patient visits cannot be billed incident to the physician. Therefore, in order to bill under the physician's provider number the physician must do all of the work that supports the code billed.
4) Consults can be performed on new or established patients. In order to bill for NPPs under the incident to provision, the service must be an integral, although incidental, part of the physicianâ€™s personal professional services, and they must be performed under the physicianâ€™s direct supervision. It does not appear from your question that the service being provided by the NPP is incidental but rather an instrumental part of the service.
5) Keep in mind that the ROS and PFSH (but not the HPI) can be provided by anyone and as long as the physician documents where that information can be located and that he/she has reviewed the information and updated/revised it as appropriate.
I hope this helps.
Maryann Palmeter, CPC, CENTC
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join