Wiki Tysabri Infusions

[melodypadilla95@gmail.com]

Hello,

I am in need of assistance, I am confused. We have a neurologist who has a NP and they both order Tysabri infusions. So we are having a bit of confusion on under who we are supposed to bill them under. If the NP is the ordering provider, then we should bill it as the NP ordering and the physician as billing and referring physician? even though the NP is the one on the authorization? Also I had another question. What if the NP is the only one who's seen the patient since they were diagnosed with MS? BUT the physician was the one who ordered the MRI and states in a patient message the patient need to see his NP to discuss the next steps for her MS. I hope that this makes sense. Any input will be greatly appreciated. Thank you!

 

[meghanhannus]

If NP has their own NPI.........

Hello melodypadilla95@gmail.com,

I would think if the NP has their own NPI number, ordered/authorized/created their own treatment plan for the infusion then the NP should be billing under them self.

What if the NP is the only one who's seen the patient since they were diagnosed with MS? BUT the physician was the one who ordered the MRI and states in a patient message the patient need to see his NP to discuss the next steps for her MS.

Is Incident-to-billing allowed in your organization? If Incident-to billing is allowed than the service must be part of the patient's normal course of treatment, during which a physician in the practice personally performed an initial service and remains actively involved in the course of treatment. The physician would need to be present in the office suite to render assistance, if necessary. If the requirements are met, then you can bill under the physician. Although, in the question you asked above I still think in that scenario the NP should be billing under them self. The MRI order, patient message and never seeing the patient does not qualify as incident-to.

Hope this helps~

M.Hannus, CPC, CPMA, CRC