Oh, that's fun! So the Emergency Severity Index works in reverse order of severity with the 9928x CPT codes. What is not to love about American healthcare finance!southerndoc wrote: ↑Thu Jun 06, 2019 10:28 pmOddly enough, patients seen by a resident physician must be seen by an attending physician but patients seen by NP/PA's aren't required by a national accreditation body to be seen by an attending physician. The requirement that attendings see patients seen by residents is part of resident supervision as required by the Residency Review Committees of the American Council on Graduate Medical Education, the board that grants accreditation for residency training programs.
I work in a hospital where a patient who is a level 4 or 5 Emergency Severity Index (lowest levels) may be seen by an NP/PA without a physician seeing the patient. Any level 1-3 seen by an NP/PA must be seen by an attending physician by health system guidelines. This isn't a national standard though. NP's/PA's rarely see level 1's (critical patients), but level 2's (chest pains, high-risk abdominal pains, abnormal vitals signs, etc.) can be seen by NP/PA's. They mainly see level 3-5 patients.
And I agree - residents must use the GR/GP modifier; and sometimes APs do or don't (haven't figured that one out yet as to who does and when; I worked for the VA, and we didn't bill them with modifiers.)
--random aside - hat tip and grateful appreciation to ED docs who do the medical triaging. You guys see a little bit of everything.