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Billing/Physician Assistant

  1. Question Billing/Physician Assistant
    Medical Coding Books
    What are the billing rules when PA is seeing patients in an office setting.
    If you have the location of the rules please inform.

    Thanks

  2. #2
    Default
    Quote Originally Posted by careyd View Post
    What are the billing rules when PA is seeing patients in an office setting.
    If you have the location of the rules please inform.

    Thanks
    It depends on the payer, and whether you intent to bill the PA under their own information, or that of their supervising physician, and what type of service is being provided.

    Without more specific info, I can point you to a few generic sources:
    For Medicare, there's "incident-to" billing...the rules are summarized here: http://www.trailblazerhealth.com/Pub...ncident_to.pdf

    http://cms.gov/MLNMattersArticles/downloads/SE0418.pdf (MLN Matters)
    http://www.cms.gov/manuals/Downloads/bp102c15.pdf (Internet Only Manual page 190)

    Article on how to bill NPP's from AAFP (2006): http://www.aafp.org/fpm/2006/0500/p45.html

    Here's one specific to Texas: http://www.texmed.org/Template.aspx?id=2273

    If you let me know more about what you're looking for, I'll help you help you find it...

  3. Default
    The payer is Trailblazer.
    We bill surgery out now under the doctor and the pa.
    He see's postop patient now while the doctor is in the office seeing new patients.
    We are wondering if the PA can see the post op and follow up patients with out the doctor in the office. If so how to code it out.

    Thanks,

    Carey

  4. #4
    Default
    Quote Originally Posted by careyd View Post
    The payer is Trailblazer.
    We bill surgery out now under the doctor and the pa.
    He see's postop patient now while the doctor is in the office seeing new patients.
    We are wondering if the PA can see the post op and follow up patients with out the doctor in the office. If so how to code it out.

    Thanks,

    Carey
    If it's routine post-op follow-up, in the global period, you can't report it. If it's outside of the global period, then you can only report it under the PA's own numbers, when the MD is not in the same building. That 'Incident-to' summary from Trailblazer is what you need.

  5. Default
    I think I found the answer in this document "incident-to" billing.

    Thank you,

    Carey

  6. #6
    Location
    Milwaukee WI
    Posts
    4,466
    Default Post Op Care
    Post op care would be reported using 99024 .... of course, you don't submit a claim for this, you just report it for your own record keeping.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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