# Shared visit?



## keke74 (Nov 1, 2010)

When you have an NP and MD signature in an ER setting and the MD writes seen and agree, is that acceptable in an ER setting? I remember reading somewhere where that was only acceptable in an Inpatient setting, does anyone have any insight on this? I would really appreciate it.


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## RebeccaWoodward* (Nov 1, 2010)

30.6.1-SPLIT/SHARED E/M SERVICE

*Hospital Inpatient/Outpatient/Emergency Department Setting*

When a hospital inpatient/hospital outpatient or emergency department E/M is shared between a physician and an NPP from the same group practice and the physician provides any face-to-face portion of the E/M encounter with the patient, the service may be billed under either the physician's or the NPP's UPIN/PIN number. However, if there was no face-to-face encounter between the patient and the physician (e.g., even if the physician participated in the service by only reviewing the patient‟s medical record) then the service may only be billed under the NPP's UPIN/PIN. Payment will be made at the appropriate physician fee schedule rate based on the UPIN/PIN entered on the claim.

30.6.13-*H Split/Shared E/M Visit*

A split/shared E/M visit cannot be reported in the SNF/NF setting. A split/shared E/M visit is defined by Medicare Part B payment policy as a medically necessary encounter with a patient where *the physician and a qualified NPP each personally perform a substantive portion of an E/M visit face-to-face *with the same patient on the same date of service. A substantive portion of an E/M visit involves all or some portion of the history, exam or medical decision making key components of an E/M service. The physician and the qualified NPP must be in the same group practice or be employed by the same employer. The split/shared E/M visit applies only to selected E/M visits and settings (i.e., hospital inpatient, hospital outpatient, hospital observation, emergency department, hospital discharge, office and non facility clinic visits, and prolonged visits associated with these E/M visit codes). The split/shared E/M policy does not apply to consultation services, critical care services or procedures.

http://www.cms.gov/manuals/downloads/clm104c12.pdf


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## cheermom68 (Nov 1, 2010)

*shared visit*

I do not allow seen and agreed to count for any split shared visit.  The MD must at least have some portion of the history or exam to qualify.
LeeAnn


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## keke74 (Nov 1, 2010)

Thanks everyone, all of the information is very helpful!!!!


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