Neurology & Pain Management Coding Alert

Question: Which code should I use for an NP (nurse practitioner) visit if the neurologist doesn't see the patient?

Florida Subscriber Answer: You should report the appropriate E/M service that the NP performs. Florida permits NPs to bill independently through collaborative physician agreements (although individual states vary in this regard). That means the NP may bill any service under his own identification number.

For instance, a patient new to the area calls the office, requesting a visit for recent low-back pain. The neurologist's schedule is full, so the receptionist schedules the patient to see the NP. The NP performs an expanded problem-focused history, an expanded problem-focused examination, and straightforward medical decision-making.

In this case, you should report 99202 (Office or other outpatient visit for the evaluation and management of a new patient ... physicians typically spend 20 minutes face-to-face with the patient and/or family) for the NP's service.