# Physician signature on NP note??



## CardioCoder79 (Dec 12, 2012)

If the NP sees the patient and does the dictation, does the Physician have to sign off on the note for the visit if the NP states "Dr. So and So was present and available for consultation during this vist"? This is NOT an 'incident to' situation. Only the NP saw the patient. 

Thanks so much!


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## OCD_coder (Dec 12, 2012)

If it was not an incident to situation, then the visit would be billed under the NP's NPI.  For documentation to meet the requirements for split/shared visits, the physician would need to examine and describe his treatment plan where he spend face to face time with the patient, including signing the note in order to bill under their NPI #.


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## LLovett (Dec 12, 2012)

*Some states require the signature*

There are often multiple different requirements at play when mid-level providers are providing services.

Some states have requirements that a physician sign off on all or even a certain percentage of a mid-level providers notes. This could also be a facility driven requirement. It could be a throw back to a misunderstanding of guidelines and it just became the way it was done.

I would suggest starting at the facility level, then move up to the state level if no internal policies explain it.

Happy hunting,

Laura, CPC, CPMA, CEMC


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## non_ee (Oct 4, 2013)

*Residency and NP*

I work with a Residency Program we have recently got accredidated to have NP do their 
residency here. We brought on staff a Nurse Practitioner APRN,BC to supervise these NP Residents. Can this APRN,BC sign off on those notes without a Physician document anything on notes? I'm concerned about our documentation. Any help would be greatly appreciated.


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