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NP billing for an in patient service performed in conjunction with a resident

Luz Posted Mon 20th of March, 2017 13:35:47 PM
I would appreciate your advice on the following scenario: A nurse practitioner (NP) provide an inpatient service in conjunction with a non-billing resident from the same specialty and department. Both the NP and the non-billing resident authored and sign the note. There is no distinction on the note of their individual participation on the service. Can that service be billed under the NP provider number?
SuperCoder Answered Tue 21st of March, 2017 09:16:43 AM


According to Medicare under the incident-to rules, a physician must follow the incident-to rules, which say nothing about cosignature. For example, 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.

Luz Posted Tue 21st of March, 2017 11:30:55 AM
Thank you. Let me clarify the question. The resident is not allowed to bill, but did a service with the NP. There is only one note with both signature but no indication of what service each provided. Is the resident allowed to provide service with an NP.
SuperCoder Answered Wed 22nd of March, 2017 01:33:04 AM


Yes, the resident is allowed only if he is present with the NP also the point in support is that the resident belongs to the same speciality.

Luz Posted Wed 22nd of March, 2017 07:46:04 AM
Thank you!
SuperCoder Answered Wed 22nd of March, 2017 23:40:35 PM

Happy to help!

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