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Thread: NP & Attending saw patient in critical care

  1. #1

    Default NP & Attending saw patient in critical care

    AAPC: Back to School
    If a NP was the first to see a patient as critical care on a given day, meets the 30 minutes, and the attending physician sees patient later on the same day and also meets critical care with 30 minutes, Is there a regulation that states we must bill under the 1st person (the NPP) for the critical care to medicare?
    Last edited by myirskc; 03-15-2010 at 06:52 AM.

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Our policy

    I do not know if there is a Medicare ruling on this. But I do know that our practice policy is that if two providers (same specialty, same practice) see the patient on the same day, all the documentation is considered as ONE E/M visit, and we always bill under the first person who saw the patient.

    The only exception is when Provider # 1 sees a patient who is stable earlier in the day; but the patient "crashes" later and Provider # 2 provides critical care. Then we code the E/M for Provider # 1; and critical care for Provider # 2.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3


    Thank you, it does help and seems like the easiest way to solve this problem. However we can't spilt/share critical care with the NP and attending and if we bill under the NP we olny get reimbursted 85% with some ins carriers. This is why I was trying so hard to see if anyway heard that we must bill under the 1st person who saw the patient, or can we pick and choose.

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