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ED Coding and Reimbursement Alert

Reader Question:

The CMS Shared Services Documentation Exemption Only Applies to E/M Services

Published on Mon Jan 16, 2012

Question:If an emergency physician sees a patient and performs an ED E/M service, but has a Non Physician Provider come in to perform a laceration repair and both provider's properly document in the chart, and sign the chart, do the E/M and procedure get billed under the physician, or does the E/M get billed under the physician and the procedure under the Non Physician Provider? Also, does it make a difference depending on the payers the bill is being sent too? Texas SubscriberAnswer:The physician can't bill for a procedure performed by the NPP. The changes from Transmittal 1776 and the rules regarding shared services only apply to E&M services. There is no mechanism for a procedure to be reported as a shared service. Procedures performed by an MLP should be billed under their ID number and paid at 85% of the Medicare allowable.The resident rules for procedures do not would [...]
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