Pulmonology Coding Alert

Reader Question:

Remember Supervision Requirements for NPs

Question: If a nurse practitioner (NP) or physician assistant (PA) performs a diagnostic test that is within his scope of practice, are there any supervision requirements? Maine Subscriber Answer: NPs, PAs and clinical nurse specialists (CNSs) may not function as supervisory physicians under the diagnostic tests benefit, according to Medicare rules. Physician billing for diagnostic testing requires the physician to supervise the study. Beware: Keep in mind that the supervision requirements for nonphysician ancillary personnel performing diagnostic tests are different from those for incident-to services. Diagnostic testing requires various levels of supervision -- general, direct or personal -- while incident-to services require direct supervision. But when these practitioners personally perform and bill for these diagnostic tests as listed in the Balanced Budget of Act of 1997, the supervision rules do not apply. An NP or PA may perform diagnostic tests as long as he follows the state scope-of-practice laws and the applicable state requirements for physician supervision/collaboration
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