A non-credentialed cardiologist

michele.fecho@readinghealth.orgmichele.fecho@readinghealth.org
in Part B Archive
If a new doctor is not credentialed yet & reads a test. The new doctor signs the note and then a credentialed cardiologist signs that same note. Can this be billed under the credentialed doctor? Thanks.

Comments

  • donself@donself.comdonself@donself.com
    edited May 2017
    who is making the medical decision making at the time of service with the test results? That should be the person billing it.

    Don

    Don Self & Associates, Inc

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  • kristine.cuddy@hc.msu.edukristine.cuddy@hc.msu.edu
    edited May 2017
    Is this part of an E/M...or the billing of the actual global service/interpretation of the test?

    Kris

    Kris Cuddy, CPC, CIMC
    Healthcare Compliance Analyst
    Compliance Office
    Michigan State University HealthTeam
    East Lansing, MI
    Ofc: 517-355-4547
    Fax: 517-353-5292


  • michele.fecho@readinghealth.orgmichele.fecho@readinghealth.org
    edited May 2017
    It is billing for the interpretation of the test.

    -
  • todd@ercoder.comtodd@ercoder.com
    edited May 2017
    The credentialed provider would have to re-read and document their findings, instead of just cosigning the note. There is no mechanism for a MD to bill for the services provided by another fully licensed MD.

    TT

  • kristine.cuddy@hc.msu.edukristine.cuddy@hc.msu.edu
    edited May 2017
    I agree. Just because the credentialing isn't in place, doesn't give credo as if one doctor is supervising another doctor. Specific carriers may have their own rules though, so I'd recommend asking the carrier(s).

    Kris

    Kris Cuddy, CPC, CIMC
    Healthcare Compliance Analyst
    Compliance Office
    Michigan State University HealthTeam
    East Lansing, MI
    Ofc: 517-355-4547
    Fax: 517-353-5292


  • janrpcs@aol.comjanrpcs@aol.com
    edited May 2017
    Exactly what I was going to say.

  • Unknown
    edited May 2017
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    I do radiology billing, you cannot bill under another credentialed doc unless they repeat the reading and become the signer. there is no incident to in lab billing.
    sharon


  • kristine.cuddy@hc.msu.edukristine.cuddy@hc.msu.edu
    edited May 2017
    Even more than that Sharon, it’s not incident to because it’s not a physician supervising a non-physician provider or other staff, or a non-physician provider supervising other staff…this is doctor to doctor. The ONLY possible way it could be allowed is if a specific carrier said it was okay.

    Kris

    Kris Cuddy, CPC, CIMC
    Healthcare Compliance Analyst
    Compliance Office
    Michigan State University HealthTeam
    East Lansing, MI
    Ofc: 517-355-4547
    Fax: 517-353-5292

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