tci Medicare Compliance & Reimbursement - 2013 Issue 16

Reader Question: Include Phone Work in Next E/M Code

Question: From his office, an oncologist reviews lab test results and, by telephone, orders additional testing and medication changes for nursing facility patients. Can the physician charge for this work if he does not see the patient face-to-face? Can a nurse performing the same services from the office charge for these services as “incident to”? Answer: No. Without a face-to-face visit the physician cannot charge for his telephone evaluation and orders. A nurse also cannot bill an “incident-to” service outside of the office. In this case, no direct face-to-face service occurred between the patient and the physician/nurse...

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