Wiki Need help with an unusual auditing situation..

[SFling]

Hello,

I have an auditing situation that I'm not completely sure about because I have not seen anything quite like it. Here's the situation... The supervising physician is disabled so he sends his PA for hospital consults and he evaluates the patient via telemedicine along with the PA. They are both billing a visit which I know is incorrect- the doc billed an initial hosp and the PA billed a subsequent, I'm just not sure exactly what to tell them is the right thing to do. I'm leaning towards saying it's an initial hosp billed under the PA because the doc was never face to face technically but I don't know in this situation 100% what to do. Any help or input on this would be very much appreciated. Thanks!!

 

[mitchellde]

Certainly you cannot bill both. I do not believe you have met the qualifications for telemedicine which would not be billed as an Initial or subsequent but you would use the codes for telemedicine, however I feel that you have not met those requirements. the only thing left is to bill one encounter using the PA NPI as the rendering provider.