# PA billing Hosp Consults



## jlb102780 (Jun 17, 2009)

I have a question that I'm not sure of the answer. This gets kind of sticky for me. I work for a Cardiology group and post the hosp charges. I just found out that our PA's do all the consults in the hosp. When I get my charges from the doctors, they give it to me as if they are doing the consults. Now when I look at the dictation, the doctors sign off on it, but it looks like the PA's are the one's writing it. Does anyone know if these are ok to bill under the doctor's names? I can't get a straight answer from anyone I work with and I can't go down to the hosp and see for myself who is seeing these patients. Any advice?


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## mitchellde (Jun 18, 2009)

If the PA is seeing the patients in the hospital setting, these may not be billed incident-to.  This comes under the definition of a shared service, however to be a shared service the physician whom the service is being billed under must have a face to face encounter with the same patient on the same day and write their own assessment note.  CR1776 states:
"However if there is no face to face encounter between the physician and the patient (even if the physician signs off on the assessment provided by the NPP), then the visit must be billed under the NPP's number."
Debra Mitchell, MSPH, CPC-H


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## LLovett (Jun 18, 2009)

I have this exact same situation with CVT PAs. The hospital requires the doctors to sign off on all the PA notes. So our PAs have to go back and sign them after the doctor does as well.

Even if there is face to face time by the physician, consults can not be split/shared visits. If they want to bill under the physician, the doctor needs to do his own work and document it. He can not simply state he agrees with the PA or just sign the note. Those would need to be billed under the PA.

Laura, CPC


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## jlb102780 (Jun 18, 2009)

Thanks so much. That's what I though too, I just needed to hear it from someone else too


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