Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

Physician and NP visit same day?

Eleen Posted Thu 15th of November, 2012 15:12:47 PM

Our NP is working with our physician same clinic. We are planning to see new patients two days a month. She will have her own visit and cover certain topics with each patient. And NP will then see the patient on the same day and cover additional topics that she will not be covering. NP will cover health maintenance issues.
Are we able to bill for the NP service if it occurs on the same day as the patient sees the physician if NP is covering an entirely different subject? The visit with NP will be 45 minutes and is primarily counseling. :confused:

SuperCoder Answered Fri 16th of November, 2012 08:58:20 AM

When a physician and an NP both have a face-to-face encounter with a patient on the same day, only one bill needs to be sent. The notes of both practitioners can be combined to decide on the level of service and one bill generated under the physician's name and PIN. So, if time is documented and the medical necessity supports both services, the practice could bill up to a level III service (99233) and a prolonged services charge (99356). Of course, the practice could also decide to bill the services under the NP's name and PIN and receive less money.

The physician and NP must be employees of the same practice.
In any shared service, both the physician and the NP must provide their portion of the services face to face.
The incident-to rules are all still in effect.
You must document medical necessity and what you actually did during the encounter.

Related Topics