John Posted Thu 04th of May, 2017 11:55:10 AM
I recently inquired about split/shared visits between a physician & APRN providing Neonatal Intensive Care Services (99477, 99478, 99479). (For your answer I was provided the standard information found in my AMA Professional CPT book outlining these codes).
I am hoping you can provide information that is more direct for my question.
I need this information to provide education and feedback to our physicians and the information provided still leaves me questioning if these services can be split/shared.
Thank You for your help
SuperCoder Answered Fri 05th of May, 2017 06:18:39 AM
Hospital Outpatient Clinic (POS = 22): NP performs and documents a portion of an E/M encounter for an established Medicare patient (e.g., history and exam). The attending physician briefly examines the patient, reviews the NP’s note, discusses the plan and documents a separate note. Since both the NP and attending MD rendered a face: face service to the patient, the attending MD may bill for the service under the split / shared visit rule. The level of service is determined based on medical necessity and their combined notes.
5. Hospital Inpatient (POS = 21): A NP working on the Medicine GI service rounds on a hospital inpatient in the morning and documents the visit in the chart. Later that same day, the Medicine GI attending physician visits with the patient (face-to-face visit), reviews the NP’s note and documents an interval history and confirms the plan of care. Either provider may bill for the combined E/M visit that day; however, only one provider may bill, not both. The attending MD may bill for the inpatient visit under the split / shared visit rule. The level of service is determined based on medical necessity and their combined notes.
6. Hospital Inpatient (POS=21): Hospital inpatient E/M service is independently performed and documented by a NPP, with the physician later making rounds, reviewing and/or co-signing the notes. The service must not be billed under the physician's name or NPI# and does not qualify as a split/shared visit. The service must be billed under the NPP's name and NPI number.
Hope this helps!