ED Coding & Reimbursement Alert - 2003 Issue 3
CMS Allows Incident-To Billing for Shared E/M Services
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Article Overview
This article summarizes a CMS update affecting shared or split evaluation and management services when a physician and a nonphysician practitioner both participate in the patient encounter. It focuses on how the policy applies in office, hospital inpatient, outpatient, and emergency department settings, and why the change matters for general surgery and other group practices. The discussion is aimed at coders, billers, compliance staff, and practice managers who need to understand the broad reporting implications of CMS Transmittal 1776.
Why This Topic Matters
The article addresses a CMS policy change that affects how shared E/M encounters are reported and who may submit the service under a provider identification number. This is important for practices that need to align billing workflows with Medicare guidance in different care settings.
What You Will Learn
- How CMS addressed shared or split E/M services involving physicians and nonphysician practitioners
- Which care settings are discussed under the revised policy
- Why the policy change is relevant to physician group billing and compliance
- How the article frames documentation and encounter participation at a general level
Who Should Read This
- Physicians
- Nonphysician practitioners
- Medical coders
- Medical billers
- Compliance staff
- Practice managers
Codes Discussed
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