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Discussion

Surgical NPs—Progress Note question adding attending?

Hi there—

We’ve been having an ongoing discussion at my hospital as to whether or not surgeons need to be CCed on to our daily surgical progress notes for billing purposes. Typically I have only been adding them if it is an initial surgical consult or a discharge summary. What is your understanding? TY! ?

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    Depends in hospital bylaws, which usually covers this. It also depends on whether you're credentialed to bill and if the hospital wants to collect 100% by having the surgeon write an addendum documenting his participation in the patient's care. Otherwise, with NP care only it's 85%, full practice authority state or not. It's not generally legally required to have the cosignature, but the above factors that come into play.

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    1 minute ago, Neuro Guy NP said:

    Depends in hospital bylaws, which usually covers this. It also depends on whether you're credentialed to bill and if the hospital wants to collect 100% by having the surgeon write an addendum documenting his participation in the patient's care. Otherwise, with NP care only it's 85%, full practice authority state or not. It's not generally legally required to have the cosignature, but the above factors that come into play.

    That makes sense. No, we don’t currently bill. It’s just funny because this particular surgeon is the only one who seems to care, so I have to remind myself to add him which is practice change..

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    On 6/7/2021 at 11:09 AM, Neuro Guy NP said:

    Depends in hospital bylaws, which usually covers this. It also depends on whether you're credentialed to bill and if the hospital wants to collect 100% by having the surgeon write an addendum documenting his participation in the patient's care. Otherwise, with NP care only it's 85%, full practice authority state or not. It's not generally legally required to have the cosignature, but the above factors that come into play.

    Also depends on the payer - some 3rd party payers do not credential APPs in my state, for example, so that gets kicked to the attending for billing. For most patients, I do my own billing.

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