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tci E/M Coding Alert - 2015 Issue 9

Billing: Identify 'New Problem' Before Billing NPP Services

For established problems, consider billing incident-to the physician. If your practice, like many, is employing non-physician practitioners (NPPs) or mid-level providers (MLPs), such as physician assistants (PAs) or certified registered nurse practitioners (CRNPs) to increase the number of patients you can see while lessening the burden on your physicians, you know that billing for the NPP’s services can be tricky. If you’re not correctly identifying the patient’s problem as new or previously established, you could be mistakenly billing encounters incident-to the physician to those payers who follow Medicare guidelines. One reader posed a question to our...

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