Otolaryngology Coding Alert

Physician's authorization of NPP's services is a rule you can't miss.The Centers for Medicare and Medicaid Services (CMS) recognizes non-physician practitioners (NPPs) for payment purposes by reimbursing physicians for services provided "incident to" a physician's care. However, CMS has made it clear in 2008's Transmittal 87 that payers will not reimburse these services unless there is physician documentation authorizing the incident-to service.You could end up dazed and confused if you don't fully understand incident-to rules. But you can't afford not to -- Medicare reimburses at 100 percent of the physician fee schedule when services are billed in the physician's name as an incident-to service, and 85 percent when billed under the NPP's name if incident-to guidelines are not fulfilled.Fortunately, you have ways to increase your knowledge about incident-to services. Here are 3 important guidelines.1. Meet CMS-Set CriteriaCMS' Benefit Policy Manual defines "incident to" as "services furnished as an integral although incidental [...]