Primary Care Coding Alert

Heads up: Skip these items and you'll be in the OIG's hot seat. Your family physician diagnoses a new patient with acute sinusitis (461.9), and bills the service with 99203 (Office or other outpatient visit for the evaluation and management of a new patient ...). His plan of care includes follow-up services to assess the patient's medication compliance and response. Two weeks later, the patient returns for her follow-up visit. The nurse practitioner (NP) checks the patient's vitals and asks how she's feeling and whether she believes the new medications are helping. The NPP also asks if the patient wants to refill the prescription. Does the service by the NPP fall under "incident-to"? It's time to be sure, because the HHS Office of Inspector General (OIG) plans to scrutinize incident-to services as part of its 2012 Work Plan.Your best bet for avoiding OIG scrutiny is not to bill incident-to unless [...]