This week's question is answered by John Burns CPC, senior consultant for DecisionHealth Professional Services.

Q.   If a Nurse Practitioner sees a patient, can we bill under the NPI of a doctor who was in the office, even if he never saw the patient and didn't sign off on the chart? We'd like to get the higher payment but we don't want to get audited.

This chart shows how the number of non-physician practitioners (NPPs) enrolled in Medicare compares to the approximate amount earned per NPP over a recent four-year period.

Your speech language pathologists now have a two-digit specialty code to specifically designate them as a provider type. 

Physical and occupational therapists take note: Enforcement officials may already have your claims under the microscope.

You and your peers are billing consultations rendered by physician assistants (PAs) and nurse practitioners (NPs) in increasing numbers every year, a Part B News analysis has found. In fact, the number of consults billed by NPs and PAs is up 874.3% since 2000. It's a trend that could mean additional money for your practice.

You won't see as many large swings in prices as you have in the past for drugs billed to Medicare starting July 1. The average sales price (ASP) calculations remain relatively stable for the third quarter, with prices increasing less than 1% on average, according to an exclusive analysis of the CMS's quarterly ASP drug list by Part B News.

When a physician creates an arteriovenous graft in a patient for dialysis (36821, $656.05 [fac.]), it has a 90-day global post-op period. But if the graft occludes within the 90 days and the patient has to have a thrombectomy (36831, $453.36 [fac.]), would you use modifier 78 (unplanned return to OR) or 79 (unrelated procedure during post-op period) on the second procedure?

Download this month's tool from DecisionHealth Professional Services from Part B News' NEW Web site, www.partbnews.com. The Tool of the Month is a Recovery Audit Contractor (RAC) appeal tracking form. The purpose of this form is to allow providers to track all of the different timelines of an appeal your practice will encounter.

This chart shows the top 10 CPT codes with the highest percent growth in allowed charges from 2007 to 2008. Like last week's Benchmark, all data comes from an April 2009 report by the AMA called "Estimated change in SGR spending from 2007 to 2008." The presence of codes like 97110 (therapeutic exercises, $28.13) isn't a surprise, since its utilization has been growing for years (PBN 11/24/08).

You'll find in the latest batch of Correct Coding Initiative (CCI) edits that nearly a third of them include anesthesia codes, including hundreds of deleted pairs involving cardiovascular stress tests and anesthesia codes that have been around since 2003. The CCI changes take effect July 1.