Just looking for more info on this. I work in dermatology and we currently have an MD who wants to perform the E/M service and have the NP come in and perform the biopsy. Our EMR only allows sign off by one provider per note unless an addendum is done indicating another sign off, which I do not find to be very good documentation, as every chart note will need an addendum for the NP to indicate she performed the biopsy only and wants those charges to be under her. Has anyone else experienced this and how did they document in the same note and bill for these services under separate providers? I feel as though they should each document their own notes separately, but they do not want to do it that way.