# MPI and Nuclear Study Supervision



## DebbieP (Feb 18, 2013)

If a physician is unable to be in the office, can a mid-level provider such as a PA or NP supervise a nuclear tech?  Billing would be for both the professional and technical components.

It is my understanding that a Locum Tenens physician or supervising equivalent MD or DO is required.  

Comments would be appreciated.


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## Amanedmaiston (Feb 18, 2013)

It has to be a doctor that supervisies. The AAPC has a coding edge article that states that CMS clarfied and Np's/PA's can't supervsie.  I think it came out in 2011


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## jewlz0879 (Feb 19, 2013)

Here are the Medicare Supervision Requirements: 

*General Supervision* - means the procedure is furnished under the physician's overall direction and control, but tghe physician's presence is not required during the preformeance of the procedure. Under general supervision, the traning of the non-physician personnel who actually perform the diagnostic procedure and the maintenance of the necessary equipment and supplies are the continuing responsibility of the physician. 

*Direct Supervision* - in the office setting means the physician mst be present in the office suite and immediately available to furnish assistance and direction throughout the performance of the procedure. It does not mean the physician must be present in the room when the procedure is performed. 

*Personnel Supervision* - means a physician must be in attendance in the room during the performance of the procedure. 

Supervision by a non-physician practitioner (e.g. nurse practitioner) does not qualify as physician supervision. However, if performance of a specific test is within the practitioner's scope of practice under state statute, the practitioner may bill for the svcs using his or her own Medicare Provider Identification (PIN) number. 

HTH


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## DebbieP (Feb 19, 2013)

So given the following coding scenario, please make comments.

Physician is the suite supervising the Nuclear Tech and provides interpretation.
Billing is:
93015
78452
A9500

Nuclear Tech is not being supervised, Physician is not in the office. Physician later interprets the results
Billing is:
93018
78452
A9500
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It was my understanding that 78452 required "in office" physician supervision being a radiology code and performing a Stress study.  Hoping to get some clarity on this.  Thanks.


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