Results 1 to 4 of 4

PA billing Hosp Consults

  1. #1
    Jacksonville Florida
    Default PA billing Hosp Consults
    Medical Coding Books
    I have a question that I'm not sure of the answer. This gets kind of sticky for me. I work for a Cardiology group and post the hosp charges. I just found out that our PA's do all the consults in the hosp. When I get my charges from the doctors, they give it to me as if they are doing the consults. Now when I look at the dictation, the doctors sign off on it, but it looks like the PA's are the one's writing it. Does anyone know if these are ok to bill under the doctor's names? I can't get a straight answer from anyone I work with and I can't go down to the hosp and see for myself who is seeing these patients. Any advice? :-)

  2. #2
    Columbia, MO
    If the PA is seeing the patients in the hospital setting, these may not be billed incident-to. This comes under the definition of a shared service, however to be a shared service the physician whom the service is being billed under must have a face to face encounter with the same patient on the same day and write their own assessment note. CR1776 states:
    "However if there is no face to face encounter between the physician and the patient (even if the physician signs off on the assessment provided by the NPP), then the visit must be billed under the NPP's number."
    Debra Mitchell, MSPH, CPC-H

  3. #3
    I have this exact same situation with CVT PAs. The hospital requires the doctors to sign off on all the PA notes. So our PAs have to go back and sign them after the doctor does as well.

    Even if there is face to face time by the physician, consults can not be split/shared visits. If they want to bill under the physician, the doctor needs to do his own work and document it. He can not simply state he agrees with the PA or just sign the note. Those would need to be billed under the PA.

    Laura, CPC

  4. #4
    Jacksonville Florida
    Thanks so much. That's what I though too, I just needed to hear it from someone else too :-)

Similar Threads

  1. Billing PA-C vs Dr. for IP Hosp consults
    By mshaw530 in forum E/M
    Replies: 1
    Last Post: 03-26-2015, 08:21 AM
  2. Discharge from hosp & admit to hosp?
    By Orthocoderpgu in forum E/M
    Replies: 0
    Last Post: 07-17-2012, 10:19 AM
  3. Consults and Hosp with Echo/Stress test
    By mcgraws in forum Billing/Reimbursement
    Replies: 0
    Last Post: 03-08-2012, 10:34 AM
  4. Psych Hosp Billing
    By swoodruff14 in forum Behavioral Health
    Replies: 0
    Last Post: 10-15-2009, 06:58 AM
  5. Ov vs hosp consults
    By Robinznest in forum E/M
    Replies: 3
    Last Post: 05-29-2009, 09:48 AM

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.