Wiki Incident to

[brownie]

Have a Dr insistant that a RN who is a clinic employee can go over and do the Pacemaker checks on his IP hospital patients and then Dr can bill for them iunder his name. My understanding- this is not acceptable.

Could anyone provide input and maybe a link with some info to share with Dr ?

Thank you

 

[OCD_coder]

Well, first, incident to does not apply in the inpatient setting. The rules would fall under Split/Shared visits. Second, unless that RN is actually a Nurse Practitioner with a Medicare number and separate NPI#, the visit would only be billed under their own NPI#. Only midlevel's can perform services in the inpatient setting. If the provider wants to bill under his NPI#, he has to see the patient and document what portion of the service he provided on that DOS.

Incident to rules only apply for RN-ancillary staff when performing procedures inside of the office would be billable services. CMS Internet Only Manual will have all of this information described in detail.

 

[brownie]

Thank you for reply.