“Incident to” is a benefit category that allows Medicare to reimburse physicians for physician services as though the physician personally performed the service, when the service was actually performed by someone other than the physician. All of the requirements for “incident to” services are encompassed in the following broad statements:
1) The reporting physician must have had a previous encounter with the patient and determined a plan of care that included the “incident to” service.
2) The physician must have ordered the service, supervised the provision of the service, and borne financial responsibility for the service’s provision.
3) The reporting physician will have an encounter with the patient subsequent to the “incident to” service.
Popular Posts
-
Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...
-
An OPPS payment status indicator is assigned to every HCPCS code. The status indicator identifies whether the service described by the H...
-
Claim Adjustment Reason Codes (CARC) CO-22 or PR-22 This care may be covered by another payer per coordination of benefits. CO-19 This is...
-
This procedure is medically necessary only when it requires the professional skills of a therapist, is designed to address specific ne...
-
Definition: The “-59” modifier is used to indicate a distinct procedural service. The physician may need to indicate that a procedure or...
-
Mohs surgery, also known as chemosurgery, created by a general surgeon, Dr. Frederic E. Mohs, is performed to remove complex or ill-defi...
-
Ambulance transportation is a covered service when the patient’s condition is such that the use of any other method of transportation would...
-
AAPC’s Certified Professional Coder (CPC) credential is the gold standard for medical coding in physician office settings and held by more ...
-
This procedure may be medically necessary for training patients whose walking abilities have been impaired by neurological, muscular, o...
-
Sentinel lymph node identification and biopsy typically involves a multidisciplinary approach. A nuclear medicine procedure called lymph...
