Wiki Multi-Layer Compression and "Incident to"

[sjsantjer]

We are a two physician office. Dr B has started a treatment plan for a patient with statis ulcers, of weekly checks and multi-layer compression bandages until healed. Dr B is on vacation and wants his nurse to change the multi-layer compression bandage while he is gone. If I read the "incident to" correctly we can't bill under Dr B since there is no direct supervision. We do have Physician A in the office. My question is should we bill code 29581 under Dr A? Dr A wont see the patient, but I think would qualify for the "incident to" billing. Also where can I find Medicare's complete rules on "incident to" what I have found so far has been choppy? Thanks

 

[acuaria76]

Incident To Billing

In this case, you would bill the procedure out under the provider who is stading in for the Dr. who is on call/covering for the physician who normally sees the patient as long as he is in the suite while the nurse changes the bandages. The guidelines for incident-to billing can be located on your Medicare Fiscal Intermediaries website but not all carriers go by Medicares guidelines, so you would need to check the guidelines for that carrier of your patient in question.

 

[sjsantjer]

No direct supervision

What if the physician that is in the office doesn't want to be the direct supervision for the doctor that is out of the office, can we bill for the service?
Or we only have RN's or MA's in the office and no supervising medical staff, is there any time that we can bill the service without having direct supervision?