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Dana Posted Wed 30th of September, 2015 15:22:10 PM

I have a practice that owns their own equipment and has an NP performing the tests with the Dr on site who does all of the reads after its done. One afternoon a week he is not there, but the NP does the service and the Dr. reads it Monday morning when he comes in. How is this billed? I know there are no modifiers because it is owned by the practice but can we bill under the Dr since he reads the studies?

SuperCoder Answered Thu 01st of October, 2015 06:35:33 AM

Thanks for your question.

You can bill this scenario under NP's provider number. we cannot bill for reading of reports.

Physician presence depends upon the provider under whose name and number the visit will be billed, the state where the services are provided, and the insurer.

if billing Medicare under an NP's provider number, a physician need not be on-site, unless state law requires physician presence. However, if billing Medicare under a physician's provider number, that physician must be on-site, within the suite of offices where the NP is practicing.

State law may require the presence of a physician or availability within a specific time frame. Insurers other than Medicare may or may not require physician presence. In general, insurers other than Medicare do not require physician presence.

Dana Posted Thu 01st of October, 2015 08:34:20 AM

I am aware we cannot bill the reads because its inclusive to the rest of the CPT, but my question

Dana Posted Thu 01st of October, 2015 08:35:27 AM

Sorry...I hit submit by accident. My question is, We cannot bill under the NP because she is not interpreting the study. The Dr is when he arrives Monday morning. Its a global code and requires an interpretation.

Dana Posted Mon 05th of October, 2015 08:23:07 AM

?????? anything?

SuperCoder Answered Mon 05th of October, 2015 08:39:21 AM

I did further research on it. Yes, you can bill it under the physician’s provider number.

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