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Primary Care Coding Alert

READER QUESTIONS:

Update FP's Number, Not Your Incident-to Coding

Published on Sun Jun 26, 2005

Question: Will the new National Provider Identifier (NPI) change how we report services incident-to?


North Carolina Subscriber
Answer: No. The CMS-issued 10-digit NPI number will replace the current identifiers carriers use, such as the provider identification number (PIN) and the unique provider identification number (UPIN). But the change will not affect your incident-to coding.

You will simply report a service incident-to using a family physician or nonphysician practitioner's NPI, instead of his current identification number.

Example: An office nurse performs a blood-pressure check for a hypertension patient who has a standing order for a BP check every six months. When your physicians or group obtain their NPIs, you'll report 99211 (Office or other outpatient visit for the evaluation and management of an established patient ...) incident-to the on-duty FP's NPI with the appropriate hypertension diagnosis, such as 401.1 (Essential hypertension; benign).
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