tci Medicare Compliance & Reimbursement - 2009 Issue 2

Coding Coach: Steer Your Incident-To Coding Using These 4 Questions

100 percent pay is possible if NPP follows physician's plan of care. If you do not consider billing "incident to" the physician when a qualified nonphysician practitioner (NPP) performs services for Medicare patients, you are letting deserved reimbursement fly out the door. Bottom line: When you bill incident-to, you garner 15 percent more per service than if you bill under the NPP's national provider identifier (NPI). Incident-to coding does have some strict rules, though. To ensure that all your incident-to claims are on target, answer these questions before billing.1. Has The Internist EstablishedA Plan of Care? To qualify...

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