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Coding for Nurse Practitioners
What is a good resource for coding for nurse practitioners? I am new to coding and was only taught how to code for a physician. Does anyone have any advise for me??
re: Coding for Nurse Practitioners
Coding is the same. Reimbursement may vary.
NP's can perform any services within their state scope of practice, and these are identified by CPT® codes.
re: Coding for Nurse Practitioners
So would it be correct to add the SA modifier to the office visits like 99213, 99214, etc?
re: Coding for Nurse Practitioners
You should not use this modifier for Medicare patients as this modifier is not covered or valid for Medicare and therefore payments may be denied
re: Coding for Nurse Practitioners
A NP will receive better reimbursement if she is billing "Incident to." This billing is done, as if the physician were the provider of care. There are very specific guidelines. CMS website defines these. For ov, the overseeing physician must be in the office, the pt must be established, and have an established care plan in the chart for the type of care provided by the NP. New pts cannot be billed as "incident to." For inpt care, hospitals often might have specific guidelines on this also. "Split services," is the higher reimbursement, and the overseeing physician also needs to see the pt. The best way to prove his/her attendance is that the physician do some part of the exam. This billing is also submitted, populating the physician as the provider. These types of billing, reimburse 100% of the fee schedule, while submitting thru the NP will result in 85% of the physician fee schedule.