decisionhealth Newsletters, Coder Pink Sheets - 2013 Issue 10 (October)
Incident-to: Don’t forget global billing rules for PA providing follow-up fracture care
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Article Overview
This article discusses how fracture follow-up services performed by a physician assistant may be viewed under incident-to billing rules. It covers the role of routine postoperative or post-fracture care, office supervision expectations, and how global periods affect whether follow-up services are separately billable. The piece is aimed at orthopedic coding and billing professionals handling non-physician practitioner services.
Why This Topic Matters
Correctly applying incident-to and global period rules helps prevent billing errors for fracture follow-up visits performed by non-physician practitioners and supports compliant orthopedic practice reimbursement.
Article Sections
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Routine follow-up care in a fracture scenario
Introduces a typical fracture follow-up situation involving a physician assistant and discusses the general type of ongoing care being addressed.
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Don’t forget what constitutes ‘routine care’
Addresses the broader issue of how follow-up services are viewed in relation to routine fracture care and ongoing treatment management.
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Check for global periods, supervision requirements
Summarizes the billing context for follow-up visits, including the role of physician presence, supervision, and when services may be handled under incident-to or billed differently.
What You Will Learn
- How fracture follow-up care is generally evaluated in an incident-to context
- Why global periods matter for follow-up services after fracture treatment
- What supervision considerations are relevant when a non-physician practitioner sees the patient
- When additional surgical involvement may be needed in a fracture-care case
Who Should Read This
- Orthopedic coders
- Medical billing staff
- Practice managers
- Physician assistants
- Compliance teams
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