ED Coding and Reimbursement Alert

Bust Shared Visit, Critical Care Myths to Max Out NPP's Value

When you bill under NPPs NPI, expect 15 percent less for service. EDs that want to squeeze the most value from their nonphysician practitioners (NPPs) work need to avoid two missteps that can take serious juice out of payout for the NPPs services. Check out these mythbusters and know when to take the higher-paying road for services your NPPs provide. Myth 1: NPPs and ED Docs Cant Team Up on E/Ms The NPP (or mid-level provider [MLP]) and the physician might share the load on certain E/M services; when this occurs, check to see if you can report a split/shared visit for the encounter. While there is no incident-to billing in the ED, shared-visit billing is an option to capture E/M services the physician and the NPP provide jointly to Medicare patients (and patients with insurance that observes Medicare rules). When you code for a shared visit, report under the [...]
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