We have a Nurse Practitioner who provides Diabetes Evaluations and follow-up Diabetes Management services. She works within our Endocrinology Department of a multi-specialty group practice. She has an Endocrinology Supervising Physician and would be billing Medicare using that physician's name. Please read the scenario and verify if we are meeting Medicare's Incident-to Guidelines.
There is a documented order from the Ordering primary care physician (who is within our group practice) stating they have requested Jane Doe, NP to evaluate and manage the patient's DM condition. However the order is very general ("evaluate and manage the pt's DM Condition"). The NP office notes are signed off by the Endocrinology Supervising Provider who is in the suite at the time of service. The NP notes are also reviewed by the original Ordering Physician, and the patient has frequent follow-up visits for the DM condition with the Ordering Physician.
We would like to know if this arrangement meets "Incident-To" guidelines. Would an "order" meet the "plan of care" requirement? If so, can we bill the claim with the Supervising Physician's name, and the Ordering Physician's name be the Referring Provider?
Thank you.
There is a documented order from the Ordering primary care physician (who is within our group practice) stating they have requested Jane Doe, NP to evaluate and manage the patient's DM condition. However the order is very general ("evaluate and manage the pt's DM Condition"). The NP office notes are signed off by the Endocrinology Supervising Provider who is in the suite at the time of service. The NP notes are also reviewed by the original Ordering Physician, and the patient has frequent follow-up visits for the DM condition with the Ordering Physician.
We would like to know if this arrangement meets "Incident-To" guidelines. Would an "order" meet the "plan of care" requirement? If so, can we bill the claim with the Supervising Physician's name, and the Ordering Physician's name be the Referring Provider?
Thank you.
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