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incident to billing in VA

Melissa Posted Mon 14th of November, 2011 17:23:24 PM

here is the question i posted and the reply i received
Question I have a newsletter from Medicare Part B answer book it states that the doctor must see patient first to diagnose problem it goes on to say that the first visit to the office under the incident to rules MCM2050B the md must perform the initial service and subsequently services frequently enough to reflect the doctors continuing active participaiton in and managment of the course treatment. Which tells me no the NP can't see a new patient in the office. Has this changed I posted the question and was told yes the NP can see a new patient.
Andrew Simmons
Posted 2 days ago #

Answer Yes, this type of newsletter must be there, as it was a myth by many practices, and most of the practices follow this with a fear of denials. But, it is not true.
A nurse practitioner can see a new patient under his/her own provider number.
Answer to Q.No.4:-
If an NP conducts a visit with a new patient, the practice must make a choice -- bill the visit under the NP's provider number or bill the visit under the physician's provider number, and have the physician, not the NP, perform and document the portions of the evaluation relevant to the choice of procedure code. The physician's signature or writing "agree" on an NP's evaluation will not suffice for Medicare. Other insurers may have different rules, but no insurer pays extra if a physician cosigns an NP's records
Next question can you go into the portion that states the md must perform and document the portions of the evaluation relevant to the choice of procedure code. Because the way I read it the MD is still doing the exam. Please explain this to me.

SuperCoder Answered Mon 14th of November, 2011 22:24:14 PM

Let me simplify:
1. An NP can conduct a visit to New Patient and can bill under his/her own NPI.
2. Incident-To service:If an MD performed the Initial Service to the patient, but subsequent services provided by the NP when the physician is present in the office, this service is to be billed under Physician's NPI.
Do you have any doubt on any of the above two points?
Below audiovisual will also help you:-
Still if you have a query, you are welcome.

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