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tci General Surgery Coding Alert - 2003 Issue 3

CMS Allows Incident-To Billing for Shared E/M Services

Thanks to a recent CMS revision to its E/M rules, general surgery practices stand to gain when both the surgeon and a nonphysician practitioner (NPP) perform inpatient assessments. According to CMS Transmittal 1776 effective Oct. 25, 2002 CMS allows incident-to billing for office and hospital inpatient, outpatient and emergency department (ED) evaluations when both the physician and a nonphysician practitioner see the patient.In office settings, "when an E/M service is a shared/split encounter between a physician and a nonphysician practitioner" and the service meets the incident-to requirements, the physician reports the service using his or her provider identification...

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