# Physician Assistant Signature



## cwilson3333 (Nov 1, 2012)

Our office is not doing electronic medical records yet, still charting.

We have a physician assistant who sees patients on a regular basis.  Can she sign off on the medical records of those patients, and does the provider have to sign also.

In the past, the provider has always initialed the PA's dictation, but we were told recently that the PA alone can sign.

Need some guidance.

CW in Virginia


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## cheermom68 (Nov 1, 2012)

Check the scope of practice for your state.  Many states require that a certain percentage of PA encounters be reviewed and co-signed by the supervising doctor.  The PA should always sign their own notes but they may need to be co-signed.
LeeAnn


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## Lynda Wetter (Nov 1, 2012)

If I am not mistaken from what I remember being told, If the PA has his own NPI # than he can sign off on his own work...as long as it is not a New patient  or Initial visit for that problem to that patient.

http://www.vapa.org/

hope that helped!
Lynda


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## cheermom68 (Nov 2, 2012)

They should always sign their own work, but there are times when the state scope of practice requires that a certain percentage is co-signed by their supervising physician regardless of who's NPI it is billed under. 

For example Indiana requires 100% co-signature within 72 hours until a PA has worked for the same provider for a certain number of hours, after that threshold is met only 50% co-signature within 72 hours is required. 

LeeAnn


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## kak6 (Nov 2, 2012)

You need to check Medicare guidlines on this subject, the provider that examined the pt needs to sign thier chart the attending MD only needs to be "identified" somewhere on pt record no signature is required.


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## cheermom68 (Nov 5, 2012)

You have to follow the Medicare guidelines, yes, but you also have to follow the state scope of practice for the PA and most states require some type of co-signature by the supervising physician.  If these requirements are not followed they could be considered practicing outside their scope of practice which could jeopardize their license.


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## ruthie72 (Nov 5, 2012)

I work in Florida at the ER/hospital..our physicians always have to co-sign with the physician.


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