Orthopedic Coding Alert

Question: Which code should I report for a nurse practitioner (NP) visit when the orthopedist doesn't first see the patient?

Florida Subscriber
 
Answer: You should report the appropriate E/M service that the NP performs. Florida regulations permit NPs to bill independently through collaborative physician agreements. That means you may bill any service under the NP's own identification number.
 
Suppose a 17-year-old patient sprains her ankle while playing soccer at school. The patient's mother phones the office, but the orthopedist's schedule is full, so the receptionist schedules the patient to see the NP. She performs an expanded problem-focused history, an expanded problem-focused examination, and straightforward medical decision-making. You would 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.
 
You should check your individual payer and state scope-of-practice guidelines to determine which services your NPs can perform.