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incident to rules

  1. Question incident to rules
    Exam Training Packages
    Hi
    I have a question about incident to rules and the documentation required. In our office we have RNs who sometimes will follow patients in the hospital when our surgeons are unavailable. What documentation from the surgeon needs to be in the chart in order for us to be able to bill for that 99231-99233? Would it follow teaching physician guidelines? Those guidelines state that the surgeon couldn't just sign off on the note, nor could they just put that they agree with the resident's note/plan. They specifically have to state they saw & evaluated the patient...... etc. Is that correct?
    Thank you

  2. #2
    Location
    Columbia, MO
    Posts
    12,570
    Default
    An RN does not possess the licensure to "follow" a patient in the hospital in lieu of the physician. You cannot charge for this as it does not follow any accepted practice. So yes the physician must be present and evaluate the patient to charge a level.
    Last edited by mitchellde; 07-26-2010 at 03:55 PM.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Evansville Indiana
    Posts
    451
    Default Incident to
    There is no such thing as incident to in the hospital setting. Debra is right. An RN is only allowed to document the same as in an office, the PFSH and ROS. The physician must perform and document all other aspects of the encounter.

  4. #4
    Location
    Columbia, MO
    Posts
    12,570
    Default
    I think she may be referring to a shared service which you can do for residents, PAs and NPs. That is the NPP can see the patient and you can bill under the physician as long as the physician sees and evaluates the same patient on the same day and writes his own progress note, just signing off on the NPP documentation is insufficient. But she is referring to RNs and as you and I have both stated that is just a flat no.

    Debra A. Mitchell, MSPH, CPC-H

  5. Default
    Thanks to all for your help. It is MUCH appreciated! Have a great day, everyone.

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