General Surgery Coding Alert - 2011 Issue 3
NPP Coding: Get Physician's Face Time On Record to Ensure Shared Coding Success
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Article Overview
This premium article covers emergency department split/shared visit billing involving physicians and qualified nonphysician practitioners (NPPs). It is aimed at coders, compliance staff, and revenue cycle professionals who need to understand when shared E/M services may be billed under the physician versus the NPP, how documentation and face-to-face physician involvement are evaluated, and how Medicare and payer policy considerations shape the process.
Why This Topic Matters
Split/shared visit billing can change reimbursement levels for common emergency department E/M services, so understanding the documentation and payer requirements can affect compliance and revenue integrity.
Article Sections
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What Are Split/Shared Visits?
Introduces the concept of split/shared visits in the emergency department and discusses which types of services are generally included. It also addresses payer context and the broader billing environment.
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What Type of Encounter Qualifies for Shared Visit Billing?
Reviews the documentation and physician participation elements discussed in the article for a visit to be treated as shared. It also notes the role of supervision and state law considerations.
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How About a Shared Visit Example?
Presents an emergency department example used to illustrate the shared visit discussion and the way the article ties together documentation, diagnosis reporting, and billing under the physician's record.
What You Will Learn
- How split/shared visits are described in the emergency department setting
- Which broad documentation elements are discussed for physician participation
- How Medicare and payer policy context affects shared visit billing
- What kinds of supervision and state-law issues are mentioned in relation to NPP services
- How the article uses an emergency department example to frame shared billing issues
Who Should Read This
- Emergency department coders
- Medical billers
- Compliance professionals
- Revenue cycle staff
- Physician practice managers
- Qualified nonphysician practitioners
- Physicians involved in shared services
Codes Discussed
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