tci Medicare Compliance & Reimbursement - 2017 Issue 13

Revenue Booster: Get Your Facts Straight on the Difference Between Incident-To and Split/Shared Visits

Tip: Your documentation defines the type of service provided. With physicians on vacation, holiday, or summer sabbatical, juggling clinical care can be a hassle, and it’s easy to forget to adjust your billing habits. Unfortunately, some practices continue to bill incident-to even when the doctor is out of town — and that’s a violation. Background: When a physician and a non-physician practitioner (NPP) work together to provide an evaluation and management (E/M) service, the situation could be considered either an incident-to service or split/shared visit. Billing a service incident-to requires you to follow well-defined regulations, and it...

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