tci General Surgery Coding Alert - 2003 Issue 3

Reader Question: Dual Diagnosis Presents Incident-To Options

Question: A physician assistant (PA) or a nurse practitioner (NP) is treating a patient incident-to a physician who earlier saw the patient for a catheter insertion. If, during the PAs interaction with the patient, the PA makes an additional diagnosis (urinary tract infection), does the physician need to see the patient again to substantiate the new diagnosis? Could we bill the earlier service as incident-to? Mississippi SubscriberAnswer: This type of situation is why PAs and NPs should have their own Medicare provider identification number (PIN). If they have their own Medicare PINs, you have two options in this case...

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