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Internal Medicine Coding Alert

Use This Incident-To Checklist to Breathe Easier During an Audit

Published on Sun Aug 28, 2005

You don't need to second-guess the way you bill your NP's services anymore

Pin down Medicare's criteria for billing your nurse practitioner's (NP) services "incident-to" your internist - and you can nab an extra 15 percent in reimbursement on each claim.

The basic guidelines for billing Medicare under the incident-to provision are:
 

  • Your NP must be the physician's employee or leased employee;
     
  • The services are within the NP's scope of practice;
     
  • The NP must provide the services in a private office setting;
     
  • The physician must perform the initial visit and subsequent established visits for the patient's acute new problems;
     
  • The physician must provide direct personal supervision of the NP's services to the patient; and
     
  • The physician must have an active part in the patient's ongoing care.

    Checklist provided by Carol Pohlig, BSN, RN, CPC, a senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia; and Mary Falbo, MBA, CPC, president of Millennium Healthcare Consulting Inc. in Lansdale, Pa.

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