2022 Gastroenterology Reimbursement and Coding Update: Concrete Solutions to Strengthen Your Foundation in GI Coding and Billing | November 2021-Update on Advanced Practitioner Billing: Incident-to and Split-Shared Services

Update on Advanced Practitioner Billing: Incident-to and Split-Shared Services

Video Transcription

Video Summary

The video discusses the topics of advanced practitioner billing and incident two services. It emphasizes the importance of correctly billing for services performed by advanced practice providers (APPs) and meeting the guidelines set by recovery audit contractors and the OIG. The video defines an incident to service as part of a patient's normal treatment course where the physician is actively involved, even if they are not present in the room during the service. The video identifies the types of providers considered advanced practice providers, such as physician assistants, certified registered nurse practitioners, and midwives. It highlights the need to separate billing guidelines from state guidelines. The video also explains the concept of shared services, where a visit is provided by a physician and an APP in the same group, and the billing is done by the provider who performs the substantive portion of the visit. It provides examples and details on documentation requirements for shared visits. The video also mentions specific policies and requirements by different payers, including UnitedHealthcare, Aetna, Cigna, and Anthem Blue Cross Blue Shield. Tips are given on keeping track of provider credentials and staying updated on payer guidelines.

Asset Subtitle

Kristin Vaughn, CPC, QMC, QMGC, CPMA, ICDCT-CM

Keywords

advanced practitioner billing

incident to services

recovery audit contractors

OIG guidelines

advanced practice providers

shared visits