tci E/M Coding Alert - 2017 Issue 7

You Be the Coder: Puzzle Out Split/Shared Vs. Incident-To Visits

Question: Can you please explain the difference between a split/shared evaluation and management visit and an incident-to visit? Nevada Subscriber Answer: When a physician and a non-physician practitioner (NPP) work together to provide an evaluation and management (E/M) service, the situation could be considered either an incident-to service or split/shared visit. Important: Medicare, and other payers that follow Medicare’s guidelines, are the only payers who follow incident-to and split/shared visit rules. Split/Shared E/M Visit: A split/shared E/M visit is “a medically necessary encounter with a patient where the physician and a qualified NPP each personally perform a...

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