Can anyone tell me if a nurse practitioner billing "Incident To" can see pediatric patients for their annual well checks? When the patient comes in for the well check, they have a new complaint such as ear pain. Upon the exam by the APN, the pt is found to have otitis media and is prescribed antibiotics. If their is only 1 note and the supervising physician did not see the patient, just signed off as being present in the suite during the visit, should we just be billing for the well check? Or should the supervising physician go in to the room and address the ear problem and prescribe the meds? How would we handle this situation?
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Wiki well checks - incident to billing
- Thread starter buppkl
- Start date
Pam Warren
True Blue
While you can bill incident-to for a well check (as long as the patient is not new, and the physician has indicated a plan for the well care visit), you may not bill incident-to for a new problem. You also can't do split/shared visits in the office setting.
What you decide to do is up to you. You can bill just the well visit incident-to the physician as performed by the APRN. If you want to additionally bill the ear infection (and you are well within your right, from a documentation perspective), they physician would have to personally see the patient, complete his/her separate documentation as a separate visit and bill under his own NPI. What you can't do is bill the well visit as incident-to and the additional E&M visit also incident-to.
What you decide to do is up to you. You can bill just the well visit incident-to the physician as performed by the APRN. If you want to additionally bill the ear infection (and you are well within your right, from a documentation perspective), they physician would have to personally see the patient, complete his/her separate documentation as a separate visit and bill under his own NPI. What you can't do is bill the well visit as incident-to and the additional E&M visit also incident-to.