If I understand the scenario correctly, this service has nothing to do with "incident to."
You state that the provider who is going to perform a procedure . This indicates to me that the reason for the visit is the procedure. The reimbursement for the procedure includes the pre- and post-operative evaluation/management necessary for that procedure. So it cannot be billed whether performed by the physician him/herself or by the PA or NP working in that same office.
For example, patient scheduled for colonoscopy. NP does the pre-procedural E/M before gastroenterologist performs procedure. NO separately billable E/M.
On the other hand. Patient scheduled for lesion removal on right forearm. However, patient arrives with complaint of rash on chest. NP evaluates and treats for rash. This is a significant and completely separately identifiable E/M performed on the same day as the procedure. You would code the E/M (under the NPs name/number) with a -25 modifier.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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