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[alices]

please help!! how do you know when to use split/shared visits? I work for a teaching hosp I do the facility and profee side, we do not do the billing, I code dx's, levels and procedure codes if any. we have DR's, PA's and NP's so when do we split/shared visits so do we have to do them or is it the responsibity of the billing co..thanks alice

 

[Andrschery]

Slit/Shared Visit

You use the split or shared visit when the MD does more than just supervise, or co-sign the charts for the MLP's. For example MLP documents, CC, HPI, PE, PFSH, ROS, and MDM, and the MD sees the patient after the MLP, and documents his findings i.e. Physical exam etc.

Hope this helps.

Cheryl

 

[Mojo]

Hi Alice:

Do you assign the provider numbers for the claim along with your CPT and ICD-9 codes? Split/shared visits will be reimbursed based on the physician's number.

For split/shared visits there has to be proof of a face-to-face encounter by the physician. To quote my former compliance director, "There needs to be ink in the box!" As Cheryl posted, the physician is required to document a portion of or all of the history, exam and MDM.


http://www.acep.org/Content.aspx?id=30478

From ACEP:
FAQ 3. What documentation is necessary for the emergency physician to indicate a shared E/M service?
The medical record must clearly identify both the NPP and the emergency physician who shared in rendering the service. The emergency physician documentation should be linked to the NPP documentation of the shared service, and affirmatively state one or more elements of the encounter. This element may be an element of history, physical examination, or medical decision-making.

In a shared E/M situation, both parties must document the work they performed. A generic attestation of "I have seen and evaluated this patient and agree with the PA notes" or a notation of "seen and agreed" or "agree with above" would not qualify the situation as a shared visit.

 

[alices]

re-another question

We don't place any numbers all we do is code the chart and put both the NP/PA initials along with the attendings initials. I thank you both for your help I think I understand a little better..alice