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Treadmill billing/supervision question

  1. #1
    Location
    Greeley, Colorado
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    Question Treadmill billing/supervision question
    Medical Coding Books
    This is a stupid question but here it is anyway:
    If a treadmill is performed by a nurse and a physician is not present but does review the results, can the provider bill for the treadmill? My answer is NO - I don't think a treadmill can be performed/supervised by anyone but a physician or NPP. So if a physician or NPP is NOT present this would be a NO NO for performing and/or billing...Is that correct?
    I'm caught in a whirlwind of cardiology issues right now, and this is not my strongest area!!
    Lisa Bledsoe, CPC, CPMA

  2. #2
    Location
    Columbia, MO
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    Default
    Was the physician nowhere in the office that day? No provider in the office at all?

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Greeley, Colorado
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    Default
    Hi Debra - Let's say across the hall from the treadmill area. So in his/her office "area". It's a large group practice.
    Lisa Bledsoe, CPC, CPMA

  4. #4
    Location
    Columbia, MO
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    As long the doc is onsite I do not think it is an issue that the nurse supervise the actual treadmill, I have observed this many times in the past especially when I worked in the hospital setting. I cannot say for sure but it just never occurred to me that it might be a problem. There was an article I read some time ago about the 99211 issue and an example that was given where you cannot bill a 99211 was when a nurse is supervising a treadmill. That is as close as I can get to seeing this documented. Maybe this will help a little.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Location
    Greeley, Colorado
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    Thanks for the feedback. I appreciate it!
    Lisa Bledsoe, CPC, CPMA

  6. Default
    hELLO,

    Debra is correct, the physician does not have to supervise the treadmill but a doctor has to be on-site. Supervision of a treadmill falls under the direct supervision guidelines set by CMS. The physician has to review, interpret the results and provide a report.

    Dolores, CPC-CCC

  7. #7
    Location
    Greeley, Colorado
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    Angry and the drama continues...
    So now, my cardiologist is arguing that he does not have to be in the building if the treadmill is performed on a non-Medicare patient, so he can still charge for the supervision (even though he isn't there but other providers are)...
    Agree??
    Disagree??
    Lisa Bledsoe, CPC, CPMA

  8. #8
    Location
    Columbia, MO
    Posts
    12,527
    Default
    No I disagree, especially in a POS 11, if you are billing using his NPI as the rendering/supoervising provider then he must be in the office suite area while the patient is there. Otherwise you use the supervising provider NPI in field 24J and line 31.

    Debra A. Mitchell, MSPH, CPC-H

  9. #9
    Location
    Greeley, Colorado
    Posts
    2,045
    Thumbs up
    Thank you Debra! I am in total agreement!
    Lisa Bledsoe, CPC, CPMA

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