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92540 and 92543 - VNG

Melissa Posted Wed 04th of September, 2013 14:17:31 PM

I looked up both of these codes in the Medicare Physician Fee Schedule and they both have a 9 indicated in Physician Supervision. This means "concept does not apply" for diagnostic testing. So I gather these would fall under the category of "incident to"? We have a doctor of audiology adminstering these tests (AuD). Does the MD need to be in the suite while these tests are being performed by the AuD? Thanks.

SuperCoder Answered Wed 04th of September, 2013 15:40:28 PM

If you're an audiologist working for an Otolarygologist and you are still billing the procedures you are providing under the NPI of the physician you are strongly urged to stop. Under the 2013 OIG Work Plan they are targeting 'Incident-to'. Licensed audiologists are recognized by the Government as qualified health care providers and should bill under their own number.

Melissa Posted Wed 04th of September, 2013 17:48:24 PM

I am sorry I should haave been more clear. The audiologist is billing under his own NPI, not the MD's. So does this mean that the MD does not need to be in the suite while the tests are administered by the AuD?

SuperCoder Answered Wed 04th of September, 2013 20:10:08 PM

Correct. The MD does not need to be in the suite as this is not Incident-to. The audiologist is billing under his own number.

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