decisionhealth Newsletters, Part B News - 2011 Issue 5 (May)
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Article Overview
This article addresses a practical Medicare Part B billing question from a rural physician office that is providing post-surgical wound care follow-up through nursing staff rather than the physician. It explains the general billing context, the role of incident-to requirements, and the need to confirm payer-specific rules when services are performed by nursing personnel.
Why This Topic Matters
It helps practices assess whether nurse-performed follow-up wound care visits may be reportable under Medicare Part B and highlights the importance of matching billing approach to the payer’s rules.
What You Will Learn
- How a nurse-staffed follow-up visit fits into Medicare Part B billing questions
- Why incident-to policy is relevant to follow-up care in a physician office setting
- Why other payers may need separate verification for similar services
- What general documentation elements are part of a nursing wound care encounter
Who Should Read This
- Physician office billers and coders
- Practice managers
- Nursing staff involved in ambulatory follow-up care
- Compliance and reimbursement staff
Codes Discussed
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