AAPC - Back to school
Results 1 to 4 of 4

Thread: incident-to services

  1. #1

    Default incident-to services

    AAPC: Back to School
    Patient was seen by Dr. Name on 1/21/10 and a plan of care was established for back and neck pain.

    Patient returned on 2.15.10, for follow-up of back and neck pain and was seen by NPP.
    NPP discontinued medication started by Dr. Name for back and neck pain.
    NPP added new medication (Gabapentin and Tramadol) for back and neck pain.

    Could this still be billed as incident-to since the NPP changed the plan of care?

    No new problems were presented by the patient or addressed by the NPP.

    NPP discussed med changes with Dr.

    Please give reason for or against incident-to. Thanks.
    Last edited by clowe; 05-12-2010 at 06:12 AM. Reason: add more information

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    I say no this is not incident to and should be billed under the NPP's NPI

    Debra A. Mitchell, MSPH, CPC-H

  3. #3


    Please share your reasoning to help me understand. Thanks.

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default Treatment plan

    The NPP was changing the treatment plan, not simply following the patient for a treatment plan put in place by the physician. THAT is why the visit must be billed uder the NPP's name/number.

    In order to be "incident to"
    1) established patient
    2) established problem
    3) existing treatment plan

    If any of the above is not met, the visit cannot be coded as incident to. (Medicare thinks "consultations" were abused?! THIS will be the next area CMS eliminates ...)

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. Incident to services
    By LFORDING in forum Orthopaedics
    Replies: 1
    Last Post: 12-06-2012, 06:04 AM
  2. Incident to services
    By schmsuz in forum E/M
    Replies: 2
    Last Post: 03-27-2012, 05:09 PM
  3. Incident-to services
    By jgiannelli in forum E/M
    Replies: 1
    Last Post: 09-18-2009, 05:27 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.