tci ED Coding & Reimbursement Alert - 2004 Issue 9

YOU BE THE CODER: Think Twice About 'Incident-To' in the ED

Question: The ED physicians want me to charge for overseeing endotracheal and nasogastric tube placements in the ED, although the respiratory therapists are the ones who performed the service.  Can we charge if the doctors don't actually place the tubes? Wyoming SubscriberAnswer: Since the CMS "incident-to" provisions do not apply in the emergency department, the physician may not charge for a procedure that other hospital personnel performed on Medicare patients.Here's how it works: Medicare has a concept called "incident-to" that allows a physician to bill for services provided by a nurse or other assistant. All of the...

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