# Incident to Rules



## DEZCOWGIRL (Jun 24, 2010)

I think we are pretty clear on who to bill under incident to rules what I need help clarifying is if it is a MA service (injection etc) we bill under the supervising Dr.  Is anyone responsible for signing off the note?  Would it be the supervising Dr. or the patient's responsible Dr.?

Same question for a NP? How does the Dr show involvement and continuity of care with the NP...by signing the note or by having monthly meetings??


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## cerullhon (Jul 15, 2010)

Doctor needs to sign off on the clinical notes.


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## SCanterbury (Aug 5, 2010)

Since the "supervising physician" (the one in the office) is credited as the "rendering physician" on the claim, and the bill is submitted under his/her number, he needs to sign the note.

The original physician who saw the patient and created the incident to situation is recorded on the claim as the "ordering physician." He is required to see the patient every so often (exact frequency not specified by CMS) to renew the incident to relationship (verify that the dx is still accurate and the current plan is sound or make changes as needed).


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