Wiki Incident-to-billing

[bpope1]

My office is debating the incident to rules. To my knowledge in order to bill incident to the physician has to be in the suite/clinic. We have an office that is connected to the hospital by a hallway and some are saying that we can bill under a physician that is on call at the hospital because that physician does go between the office and the clinic while on call. Any knowledge on this subject would be very helpful!

 

[Bready]

Incident to

I think your coworkers broader interpretation used to be allowed but carriers are now narrowing the definition to mean: "physically present in the office suite and immediately available." If the physician has to come from another area(the hospital) then billing incident-to wouldn't be appropriate.

 

[mitchellde]

The incident to regulation states the provider must be within hue narrow confines of the defined office suite area.