ABSTRACT
The term incident to is defined as services or supplies furnished as an integral (composed of parts that together make a whole), although incidental (relating to or accompanying something more important), part of the provider's professional services rendered during the course of diagnosis or treatment. Such services are often referred to as a nurse visit. Nevertheless, when nurses provide "incident to physician services," the provider must be available to provide support. This article discusses the criteria necessary for nurses to deliver incident to services.
Subject(s)
Legislation, Nursing/standards , Ostomy/nursing , Urinary Incontinence/nursing , Wounds and Injuries/nursing , Medically Underserved Area , Nurse Practitioners/legislation & jurisprudence , Outpatient Clinics, Hospital , Physician Assistants/legislation & jurisprudence , United States , WorkforceABSTRACT
How does a clinician determine appropriate billing for wound care services? For Medicare and Medicaid patients, billing-related regulations are developed and promulgated by the US Centers for Medicare & Medicaid Services (CMS). This article will show how to access and use the CMS Web site as a resource for finding necessary information pertaining to billing guidelines and appropriate codes, including edits that prevent billing multiple procedures together and the use of modifiers that may allow an additional billing. Further discussion focuses on the importance of regular visits to this Web site since it is regularly updated as changes occur in billing or reimbursement policies. Therefore, investing the time to check the site for the latest updates can make a critical difference in your success with reimbursement for wound care services.