Coding Coach: Steer Your Incident-To Coding Using These 4 Questions

Why This Topic Matters

Incident-to billing affects whether a practice can report certain services under the physician rather than the nonphysician practitioner, which has direct compliance and reimbursement implications. Understanding the general requirements helps practices reduce billing risk and maintain proper documentation.

Article Sections

1. Has The Internist Established A Plan of Care?

   This section discusses the need for an initial physician visit and an established care plan before certain follow-up services can be considered. It also introduces a general example of office follow-up care in a Medicare setting.

2. Is The NPP Licensed And Qualified?

   This section covers practitioner credentialing and the need to confirm that the nonphysician practitioner meets applicable state and federal requirements. It references the types of practitioners commonly involved in this setting.

3. Did the Visit Meet Supervision Requirements?

   This section addresses the supervision component of incident-to billing and the role of physician availability during the service. It emphasizes the importance of meeting Medicare supervision expectations.

4. Have I Established A Link To Documentation?

   This section focuses on documentation practices that help show physician involvement in the patient’s course of treatment. It also notes broader compliance attention to nonphysician services.