Wiki Physician and PA see the patient in the office setting

[SSweetland]

Can someone please guide me to a policy or documentation to provide for education.

The physician assistant and the provider both see the patient with a face-to-face visit (Medicare) and we can not do "incident to billing".
the provider documents his PA gave the injection into the knee under his direct supervision. There is no procedure note done by the PA. The provider is billing for the office visit and the injection under his NPI with a complete note. Based on Medicare and not being able to do "Incident to Billing" can we bill the injection under the providers NPI since he did go into the room face-to-face and it was direct supervision.

thank you
Sheila

 

[mhstrauss]

Can someone please guide me to a policy or documentation to provide for education.

The physician assistant and the provider both see the patient with a face-to-face visit (Medicare) and we can not do "incident to billing".
the provider documents his PA gave the injection into the knee under his direct supervision. There is no procedure note done by the PA. The provider is billing for the office visit and the injection under his NPI with a complete note. Based on Medicare and not being able to do "Incident to Billing" can we bill the injection under the providers NPI since he did go into the room face-to-face and it was direct supervision.

thank you
Sheila

Was the injection the only service that was provided by the PA?

If the injection doesn't meet incident-to guidelines, it cannot be billed under the MD's NPI.

Also, I'd be wary of the fact that the PA didn't document his own procedure note. I can't remember with certainty, but I'm pretty sure providers must document their own procedure notes (with the exception of scribes, but since the MD wasn't in the room when the PA gave the injection, this can't be a scribe situation). Did the PA at least sign the finished document?

 

[SSweetland]

Physician /PA

That is where my concern is and will be addressed but I wanted to verify do to the fact we do not do "incident to billing". I believe the physician is looking to the fact it is his PA and he was in direct supervision of the procedure that he should get credit. The PA has their own NPI and is within their scope to do knee injection, but their should be a procedure note provided by the person who performed the procedure. Is there anything I can print from a guideline that can explain to the provider. I appreciate your help.