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99213 and higher

  1. #1
    Default 99213 and higher
    Medical Coding Books
    Good morning,

    I have a question regarding service 99213 and higher. I was under the impression that the doctor not a PA had to perform the exam (HPI, exam & MDM). Is this correct or can a PA perform these exams as well?

    Thank you in advance for any information.

    Beth Manus CPC

  2. #2
    Milwaukee WI
    Default PA or NP may perform
    The PA or NP may perform and bill for all services within his/her scope of practice. I've had PAs perform and bill all levels of E/M service (as per documentation, of course).

    You will bill under the PA or NP's NPI and name if this is a new problem. You can use the physician's name/number (i.e. "incident to" billing) ONLY if this is for an existing problem and an existing treatment plan the PHYSICIAN has previously outlined.

    If there is ANY deviation from the existing treatment plan ... e.g. PA changes a medication or orders a new diagnostic test ... then you MUST bill the service under the PA/NP's name & number.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Thank you very much for your help.

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