# Incident to Billing for PA



## fallondderm@hotmail.com (Oct 31, 2013)

Want to clarify something please....

Established pt with an established dx can go under the DR. But what if it is all established but also has a new problem as well. Can you still bill incident to or non incident because of the one new diagnosis???

Please advise....thank you!


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## RFoster1 (Oct 31, 2013)

*Incident To*

Great question.  I would guess the patient would either need to be rescheduled under the physician for the new problem or have the physician called into the room and bill it under MD.

Interested in seeing what responses you get.


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## mitchellde (Oct 31, 2013)

If the patient presents with a new problem, or if the treatment needs to be adjusted, then it can no longer be incident-to.  This will then need to be billed using the PA's NPI or it can be a shared encounter, where the physician must also examine the patient and write an independent note.


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## fallondderm@hotmail.com (Oct 31, 2013)

Yes, when two different circumstances are in the same situation, which one applies?

My Dr. is actually who asked me this.....


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## mitchellde (Oct 31, 2013)

fallondderm@hotmail.com said:


> Yes, when two different circumstances are in the same situation, which one applies?
> 
> My Dr. is actually who asked me this.....



I am not understanding this question.. Does my previous reply not answer your question?


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## fallondderm@hotmail.com (Oct 31, 2013)

It was not to your answer. It was regarding the first reply. Apologize for the misunderstanding, Thank you for clarifying and helping to solve this for me.


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## mssalemny (Nov 11, 2013)

I would go with a  shared visit if possible, otherwise the patient would need to be rescheduled until a MD was available. PA' are allowed to follow a plan of care established by an MD. Unfortunately, not many practices understand the incidient to billing rules.


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