Forum - Questions & Answers

May 24th, 2010 - tracyc271 30 

Admission to the hospital

We have an NP up at the hospital that will do the H&P for the doctor on an admission, the doctor will then go up and see that patient. On the NP's note they are signing the notes... Jane Doe, NP dictating for Dr. Smith.

My question is...

If Dr. Smith is the patients actual Oncology dr here in the office, but the rounding doctor for the hospital that day is Dr. Jones, shouldn't her signature be reading..
Jane Doe, NP dictating for Dr. Jones if Dr. Jones is the one seeing the patient that day?

May 24th, 2010 - nmaguire   2,606 

admit

Medicare: Shared Visit= both NP and MD record their own notes. If the NP does the H&P, the NP documents this with her own note. The MD then sees the patient and notes his/her participation in the face-to-face encounter. This is billed with the admitting physician name, and modifier AI on the appropriate 99221-99223 code, encompassing both notes. The instructions found in the Medicare Claims Processing Manual at §30.6.5 state: “Physicians in the same group practice who are in the same specialty must bill and be paid as though they were a single physician.

May 24th, 2010 -

i think it is more simple than Nancy's reply

The answer I think she was looking for is that the dictation should say "dictating for Dr X who has seen the patient and formulated the diagnostic plan" So if the patient was seen in the office by Dr Smith and he admitted the patient then use his name. If the patient came in thru the ED and Dr Jones was the doc covering the hospital patients, then use her name.

May 26th, 2010 - Codapedia Editor 1,399 

Shared services

but be careful: An NP can't "dictate" for an MD and bill under the MD's provider number for Medicare patients unless it meets the criteria of shared services rules.

Look here for details:

http://www.codapedia.com/-article_356_.cfm



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