Wiki Incident to in hospital setting

[rnewsome]

Supervising physician needs only to be in the suite and readily available if needed. Our office is on hospital campus, but not in the hospital building itself. We have not been billing incident if physician was not in the hospital when PA was seeing follow up visits, but recently had billing management change and have been directed to bill incident to if physician is in office, but still on hosptial property. Need clarification as to if "being on campus" is okay to bill incident to.

Thanks........

 

[mitchellde]

No it does not qualify. Incident to cannot be applied to inpatient encounters at all. In the office setting, the MCM states the provider must be within the narrow confines of the define office suite area. Can you look out the exam room door and talk to the provider.

 

[rpetruziello]

If your services are billed as a 22 place of service (hospital outpatient) incident to is not permitted in that setting.

Only an office base practice billing with an 11 place of service is permitted to bill under incident to guidelines.

 

[debflutter]

at the inpatient setting, it would be a shared visit, if the physician saw the patient on the same date. Each provider would dictate their part of the exam and code utilizing both dictations. Or bill under the PA/ARNP PTAN if they are the only provider examining the patient on that day. Incident to is only in the office setting.