NPP Question

Mr. Weiss

I read all your articles on "Split/Shared Visits and I use it as a guide.  I have a question if an NPP helped gather information along with the physician and the physician tells the NPP what to dictate, can the NPP act as a scribe and dictate the consults, critical care and H&P's notes. There is some confusion regarding this issue with the physicians. 

I feel that they can't as there is no way anyone reading the note can determine whether the physician did the work or the NPP did the work.  How would you handle this situation.

Thank you very much for all your articles in the BC Advantage, they have been helpful.

Patricia McDade, CPC, CMC


Hi Patricia:

Thank you for the email yesterday. I am glad to know my articles are helping you out. With regard to your question; the actual question is who performed the actual work on the patient, meaning who performed the History, Examination as well as developed the treatment plan? In my opinion, If you say the physician did all of the work and the NPP was there merely as a scribe then the answer to your question is yes, the note can be dictated by the NPP but I would make sure there is a notation either at the top of the note or at the end of the note stating that the key components (HX, EX and MDM) were performed by the physician and only the note was dictated by the NPP. Please keep in mind this is for Split/Shared services in the inpatient setting.

I do hope this answer helps...