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Need your advice/opinions...

  1. #1
    Default Need your advice/opinions...
    Medical Coding Books
    We realize that shared visits do not exist in the office setting. So for those of you billing a consult or new patient visit -

    Have you ever come across this scenario:

    The PA performs part of the visit and the physician performs part of the visit, but the physician is the one who submits billing for the visit. Both the PA's name and the physician's name appear on the note, but the note does not specify who did which part of the visit - and the note is electronically signed by both the PA and the physician...

    Would this pass an audit by an ins. company or by CERT? Or does the consult or new patient visit have to be performed entirely by the physician alone to be billed under the physician? (I think I know the answer to this, but I need supporting and/or opposing view points to help me convince a physician.)

  2. #2
    Location
    Duluth, Minnesota
    Posts
    1,133
    Default
    I'm curious, what makes you think shared visits don't exist in the office setting?

    a shared visit means the encounter with the patient is "shared" between the physician and a non-physician practitioner. (this can be NP, PA, CNS or CNM), documentation must reflect "shared" services.

    an example of shared visit would be:
    1) The NPP takes the comprehensive history for a new patient in the office and the physician completes the exam. Together they do medical decision making. <--that's a shared visit and documentation should reflect it.
    Donna, CPC, CPC-H

  3. #3
    Location
    North Carolina
    Posts
    3,126
    Default
    Consultations can not be performed as split/shared visits.

    http://www.cms.hhs.gov/MLNMattersArt...ads/mm4215.pdf

    Below is a link that elaborates on split/shared visits....

    http://www.cms.hhs.gov/transmittals/...ads/R178CP.pdf

  4. #4
    Default
    thank you for the links.

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