tci E/M Coding Alert - 2014 Issue 4

Reader Question: Focus on Level of Physician Involvement For Incident To

Question: My physician has a patient that requires anti-coagulation monitoring in the office. Can we provide this as “incident to” services with a nurse practitioner performing the monitoring? Wisconsin Subscriber Answer: Yes, as long as you make sure the requirements for billing the service incident-to are met. CMS states the requirements in MLN Matters article SE0441 as the following: 1) The “incident to” services performed in the office are part of a course of treatment that the patient’s physician planned when she personally performed the initial service.2) The physician is actively involved in the course...

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