Wiki E & M visit with MD & NP

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sadieandbrian

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Looking for some help or possibly some documentation on how to handle this. We have a nurse practioner who is seeing patients, she is performing & dictating the HPI & Exam portion of the visit. Then the doctor is coming into the room, and she is dictating the imaging review, impression & plan.
So both providers are dictating portions of the note.

Can this dictation be combined into one note? If so, do they both need to sign the note? And who would be bill under...the PA or the MD?
 
this sounds like it may qualify for "incident-to" since shared-care cannot be billed in the office setting. If the qualifications for incident-to are met then it can be billed under the MD's NPI and receive 100% reimbursement, if not then it must be billed under the PA's NPI and reimbursement will be 85%.
 
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