Wiki Medical Coder/MRT

[cjmabreece]

I work in a Psychiatric State Facility Hospital in NJ. I only take care of the Medicare Part B billing for the patients. Can anyone tell me if the physician isn't present during a patient encounter, but the APN documents it, is that billable? What is needed for documentation for that visit? Can a physician just sign it?

 

[thomas7331]

'Incident to' billing is not allowed in a facility setting under Medicare Part B regulations. Services provided to patients in a facility can only be billed to Part B by the individual who performed them. The only exception I know of is for a 'shared visit' in which both providers see the patient and perform a portion of the E/M service, in which case the visit can be billed under the physician. But if the physician did not have a face-to-face encounter with the patient or did not document seeing the patient, then the visit cannot be billed under the physician's credentials. If the APN can be enrolled with Medicare, then it can be billed using the APN's credentials.

 

[cjmabreece]

Thank you Thomas, that's what I thought.