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FP vs IM and same TIN

  1. #1
    Location
    Greeley, Colorado
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    2,045
    Question FP vs IM and same TIN
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    When billing under the same TIN, are Family Practice and Internal Medicine considered "the same" and therefore a patient from FP cannot be coded as new to IM? This is what I believe, but unfortunately cannot find it in writing...
    Lisa Bledsoe, CPC, CPMA

  2. #2
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Does anyone have any information on this topic?
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Default Different specialties
    They are both recognized specialties so the FP patient that goes to IM is new and vice versa.

    http://www.cms.gov/MedicareProviderS...CPTaxonomy.pdf

    Hope this helps,

    Laura, CPC, CPMA, CEMC

  4. #4
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Thank you for the link Laura. I assume the physicians must be credentialed with each insurance carrier with the correct taxonomy code for proper recognition and reimbursement? I don't do the credentialing so I'm not sure how this works.
    Lisa
    Lisa Bledsoe, CPC, CPMA

  5. #5
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    Lisa, I used to work in the provider area at an insurance company. Most do list the provider's specialties and taxonomy numbers so it shouldn't be a problem. Sometimes, in multi-specialty groups, the insurance co. may have a problem because of all the same tax ID; but most have updated their software to recognize specialties and/or taxonomy codes. You should be OK with most insurance to bill a NP visit with the different specialty. We counted both FP and IM (along with Peds) as primary care, but different specialties.
    Hope this helps!
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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