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ED Coding and Reimbursement Alert

NPP Coding:

Get Physician's Face Time On Record to Ensure Shared Coding Success

Published on Thu Feb 10, 2011

Medicare will let the duo 'team up' to provide certain services.ED coders that don't recognize every shared (or split) visit that the physician and qualified nonphysician practitioner (NPP) provide are costing their EDs money -- potentially a lot of money.Breakdown: Billing appropriate split/shared visits means that you may be able to code the E/M service under the physician's National Provider Identifier (NPI), which will garner the ED full reimbursement for each code.Alternative: You bill under the NPP's NPI even when you can use the physician's, which results in 85 percent reimbursement. Consider the payout for 99283 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and medical decision making of moderate complexity ...), a common ED E/M service that NPPs provide.The average national payout for 99283 is $61 (1.34 transition facility relative value [...]
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