Wiki MD and NPP prevetive visit same DOS

[Lisa Bledsoe]

Within our IM dept we have mostly male docs and 2 female NPP's. If a female patient wants her "99397" with male Dr. Z and her "G0101, Q0091" with female NPP on the same date of service, is this ok?
My thought is that male Dr. Z could do 99397 and female NPP could do G0101 and Q0091 as incident to, but after discussion with the business office manager her thought is that the NPP services would be non-incident to based on ICD-9 coding...and if that's the case we couldn't do the carve out for the G0101 and Q0091 from 99397...
I'm beating my head against the wall on this one...any help is much appreciated!!!

 

[Pam Warren]

dontcha love it?

Since our midlevels are credentialled to bill under their own name, we don't bill them as incident-to.

We bill the 99397 under the MD, and the Q0091 and G0101 under the NPP.

Since they drop on different claims, the -25 isn't usually necessary for the preventive visit.

Our business managers aren't coders, either. Oops....did I say that out loud?

have a good weekend.

 

[Lisa Bledsoe]

LOL - thanks for the feedback AND the LAUGH Pam!!!!