Wiki incident to coding

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tarism

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We have a PA and a NP in our office. Our biller has been looking on the internet and has told me they can only see someone under their name if they are following up on something like headache, for example. from seeing the dr first. Also, can the mid levels see a patient if they are new for the first time? She has got me all confused. I thought if they were credentialed w an insurance they could see anyone for anything. Please someone explain just what the incident to means...I know they only get 80% of allowed amount, if under their name. Please someone help me get the info straight so i can explain to her.


THANK YOU!!

TEE
 
Incident to guidelines are easy once you know them...I code them everyday and PA/NP can see new pts as well....we have the coding guidelines to go by...like Medicaid pts are billed to the PA/NP only if they saw that pt but no commercial plans can be billed to PA/NP- to physician only...with Medicare if pt is a new pt bill to PA/NP, if est pt and plan of care was changed for ex: prescribed new meds, procedure or labs ordered, or if meds were changed or Rxed the PA/NP can be billed for that visit...as long as supervising physician is in the office that same day/time of visit and encounter was signed by both, But if PA/NP saw this est pt and nothing was changed physician must be billed for that visit. I hope I explained this a little better, if I was at the office I could definitely tell you exactly how it is written.
 
Can you tell me where to get this info so we can print it out? she obviously is looking in the wrong place. She always wants to be shown!! And thank you!!
 
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