tci General Surgery Coding Alert - 2003 Issue 4

Reader Question: New NPP Rules Affect Hospital,Not Office,E/Ms

Question: I've heard that CMS issued a memorandum regarding new nonphysician practitioner (NPP) guidelines. Will this affect me? Illinois SubscriberAnswer: The new regulations mainly affect billing for hospital visits (for example, 99221-99223, Initial hospital care) rather than office visits (such as 99211-99215, Established patient office visit ...). Physicians can now bill E/M hospital services even if the NPPinitiates treatment, provided the doctor visits the patient later that day. CMS Transmittal 1776 (change request 2321), dated Oct. 27, 2002, states, "when a hospital inpatient/hospital outpatient or emergency department E/M is shared between a physician and an NPP from the same...

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