Julie Posted Mon 22nd of February, 2016 11:54:08 AM
If a new patient presents to the clinic for a pregnancy confirmation with a nurse practitioner, and due to office protocol, the nurse practitioner does not bill for the visit. When the patient returns to see an MD for their initial OB visit, can the MD bill a new patient or established patient visit. No charge is being billed to the insurance company by the nurse practitioner.
SuperCoder Answered Tue 23rd of February, 2016 03:01:38 AM
First, when the nurse practitioner, NP sees a patient for a new problem, he/she will need to bill under his/her own PIN. Incident-to guidelines do not allow an NP to bill incident-to a physician’s services (i.e., under the physician’s PIN) when a new problem is addressed. This could happen in a situation when the patient was scheduled to be seen for an established problem but brings up a new problem during the course of the visit. Once a new problem is introduced, the visit would need to be billed under the NP’s PIN, not the physician’s PIN.
This means MD will bill a new patient visit for that patient.
It is also important to check with each of your carriers before billing services incident-to.