# Treadmill billing/supervision question



## Lisa Bledsoe (May 13, 2010)

This is a stupid question but here it is anyway:
If a treadmill is performed by a nurse and a physician is not present but does review the results, can the provider bill for the treadmill?  My answer is NO - I don't think a treadmill can be performed/supervised by anyone but a physician or NPP.  So if a physician or NPP is NOT present this would be a NO NO for performing and/or billing...Is that correct?  
I'm caught in a whirlwind of cardiology issues right now, and this is not my strongest area!!


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## mitchellde (May 13, 2010)

Was the physician nowhere in the office that day?  No provider in the office at all?


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## Lisa Bledsoe (May 13, 2010)

Hi Debra - Let's say across the hall from the treadmill area.  So in his/her office "area".  It's a large group practice.


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## mitchellde (May 13, 2010)

As long the doc is onsite I do not think it is an issue that the nurse supervise the actual treadmill, I have observed this many times in the past especially when I worked in the hospital setting.  I cannot say for sure but it just never occurred to me that it might be a problem.  There was an article I read some time ago about the 99211 issue and an example that was given where you cannot bill a 99211 was when a nurse is supervising a treadmill.  That is as close as I can get to seeing this documented.  Maybe this will help a little.


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## Lisa Bledsoe (May 13, 2010)

Thanks for the feedback.  I appreciate it!


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## deeva456 (May 13, 2010)

hELLO,

Debra is correct, the physician does not have to supervise the treadmill but a doctor has to be on-site. Supervision of a treadmill falls under the direct supervision guidelines set by CMS. The physician has to review, interpret the results and provide a report. 

Dolores, CPC-CCC


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## Lisa Bledsoe (Aug 16, 2010)

*and the drama continues...*

So now, my cardiologist is arguing that he does not have to be in the building if the treadmill is performed on a non-Medicare patient, so he can still charge for the supervision (even though he isn't there but other providers are)...
Agree??
Disagree??


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## mitchellde (Aug 16, 2010)

No I disagree, especially in a POS 11, if you are billing using his NPI as the rendering/supoervising provider then he must be in the office suite area while the patient is there.  Otherwise you use the supervising provider NPI in field 24J and line 31.


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## Lisa Bledsoe (Aug 16, 2010)

Thank you Debra!  I am in total agreement!


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