• My Account
    • Login
  • Contact Us

CodingIntel

Medical coding resources for physicians and their staff. CodingIntel was founded by consultant and coding expert Betsy Nicoletti.

  • Join Today
  • What is CodingIntel
    • About
    • Become a Member
    • FAQ
  • Free Resources
    • Free Resources Overview
    • Blog
    • Everyday Coding Q&A
    • Newsletter
    • Can I get paid
  • Coding Library
    • E/M Changes
    • How Physician Services Are Paid
    • In Person E/M
    • Prevention & Screening
    • Care Management & Remote Monitoring
    • Surgery, Modifiers & Global
    • Diagnosis Coding
    • New & Newsworthy
    • Speciality
    • Practice Management
  • Webinars
    • Webinars
    • Coding Guides
    • Quick Reference Sheets

Teaching physician rules | Bedside procedures

Question:

Can an attending bill for a bedside procedure that a resident did without the attending being present? If so, is this billed at 85% like a PA or NP?

If a PA or NP is overseeing a bedside procedure that a resident is preforming how is this billed (no attending is present at the bedside)? Is it billed under the supervising attending or under the PA/NP who is present or in a different way?

Answer:

Neither of these are billable services. Let’s take them one at a time.

First, the teaching physician rules are Medicare rules that allow for payment for services provided jointly by an attending and a resident. The service is billed under the attending’s provider number. There are different rules for E/M services, minor procedures, major procedures, endoscopies, and time-based codes.  There are in-depth articles, and a quick reference guide on this site.

For teaching physician rules only, a minor procedure is one that takes less than 5 minutes to complete. In order to bill for a procedure that takes less than 5 minutes, the attending must be present during the entire procedure. The attending, resident or nurse can document that the attending was present.

For all other surgical procedures, the attending must be present for the key and critical components of the procedure. The attending decides what parts are key or critical. The attending must be available to provide assistance for all of the procedure.

So, if the attending wasn’t present, the attending may not bill. And of course, the resident can’t bill for the service.

As for the second question, NPs and PAs are not considered attending physicians and whether they are supervising or not, they may not bill for services provided jointly with a resident. So, again, no billing.

Read more about teaching physician rules

View all Everyday Coding Q&A’s

Get more tips and coding insights from coding expert Betsy Nicoletti.

Subscribe and receive our FREE monthly newsletter and Everyday Coding Q&A.

Sign up

We will never share your email address. Unsubscribe anytime.

Last revised June 28, 2021 - Betsy Nicoletti
Tags: teaching physician rules

Wondering about the rules for HCC coding?

Wondering what the rules are for HCC coding, and where you can find them? This video answers your questions. The topic is important to medical practices because risk-adjusted diagnosis coding is part of Medicare Advantage contracts, many commercial contracts and Accountable Care Organizations (ACOs). Sign up for our monthly newsletter to download the whitepaper and watch the video.

Sign Up Now

Recommended Resource

You’ve coded it, but you still have to fight to get paid! We’ve partnered with Elizabeth Woodcock to give you the tools and strategies you need.

Find them here!

Latest Intel

Coding Principles for Practice Administrators | Webinar

Coding Principles for Practice … Read More...

CPT Coding for Obstetrical and Gynecological Procedures | Webinar

Who Runs the World? GIRLS!!: CPT Coding for … Read More...

Payment denials for unspecified codes

From the day coders got their first glimpse at … Read More...

Behavioral health coding compliance

Compliance Lessons from the OIG In March 2022, … Read More...

Browse By Categories

Browse Content

  • Articles
  • Coding Guides
  • Everyday Coding Q&A
  • Videos
  • Can I Get Paid to
  • Blog
  • Webinars

Tags

behavioral health_cpt codes behavioral health_E/M services care management category of service CMS updates Code sets and reimbursement compliance issues CPT codes for preventive services CPT updates critical care services dermatology_E/M services dermatology_essential resource dermatology_procedures E/M frequency data E/M medical decision making E/M overview E/M reference sheets E/M rule changes FQHC general surgery_diagnosis coding general surgery_E/M services general surgery_modifiers general surgery_procedures global surgery issues HCC diagnosis coding ICD-10 coding level of service_MDM level of service_time medicare incident-to and shared services minor procedures modifiers other E/M services Preventive and problem visits preventive services for medicare primary care_diagnosis coding primary care_E/M services primary care_essential resource primary care_modifiers primary care_other E/M services primary care_preventive services primary care_procedures remote physiologic monitoring screening and counseling for behavioral conditions teaching physician rules telehealth
  • What is CodingIntel
  • FAQs
  • Terms of Use
  • Privacy Policy
  • Contact

Our mission is to provide accurate, comprehensive, up-to-date coding information, allowing medical practices to increase revenue, decrease coding denials and reduce compliance risk. That's what coding knowledge can do.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.

Copyright © 2022, CodingIntel
Privacy Policy