tci General Surgery Coding Alert - 2003 Issue 3

Keep Tabs on Surgeons Whereabouts to Avoid Incident-To Snafus

A surgeon's phone call is not enough to allow a surgery practice to bill "incident-to" services physicians must be on-site if they hope to reap the lucrative rewards of incident-to billing. The U.S. Department of Health and Human Services Office of Inspector General's (OIG) 2003 Work Plan states that it intends to scrutinize "several potential" nonphysician practitioner (NPP) billing vulnerabilities in 2003. Consequently, general surgery practices need to ensure compliance now to avoid problems with potential payer and federal audits. The Medicare Carriers Manual (MCM) specifies the following guidelines for billing incident-to services: The physician must be on-site...

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