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Tag Archives: Nurse

Medicare XRays for Nurse Practitioners

Posted on by
Apparently there were a lot of denials around 2013-2014 for not split billing the xrays for NPs.
From what I have read, NPs are not allowed to supervise the technical component and therefore cannot bill the technical component. How do you code the xrays for NPs?
If you split bill them between the NP for the professional component and the MD for the technical component, does it require a separate read or a signature on the NPs dictation for the supervising physician? I am just recently learning about this guideline and being told that they should be billed separately but there are no denials involved for anyone to have known this was an issue?

Can anyone help?

Medical Billing and Coding Forum

Nurse visit and office procedure

Posted on by
My office is wondering why I do not bill the nurse visit(99211) with office procedure(granulation tissue removal). I explain that it is a NCCI edit. My office would like to have documentation stating why. I tried looking the NCCI website for further clarification. Do anyone know where I could find references for regarding E&M and procedures(office)?

Medical Billing and Coding Forum

Billing for a Nurse Practitioner in Training?

Posted on by
Is it possible for a new Nurse Practitioner (not credentialed – still getting hours) to bill for exams/services under the supervision of another fully credentialed Nurse Practitioner? If so, what documentation would we need in the charting and how would this go out on claims?

Thanks in advance for any info you can provide.

Medical Billing and Coding Forum

Billing for non-credentialed Nurse Practicioner

Posted on by
We have a new NP that is not yet credentialed with all payers (only MCR and MCD). The physician wants to bill everything under his NPI. Not all of the encounters meet incident to requirements, some are new patient visits or new chief complaints. Also, not all payers go by MCR guidelines on incident to billing.
Is there any LEGAL way to bill under the doctor’s NPI until the credentialing comes through for the NP? I’ve searched exhaustively and I can’t find any clear answer.
Can these charges be billed with SA modifier?

Please help!

Medical Billing and Coding Forum

Work comp and nurse case managers

Posted on by
I bill for an urgent care clinic in Texas that does a lot of occupational medicine. We recently learned that when a nurse case manager accompanies a Work Comp patient for a visit with the physician, we can bill the nurse case manager at time of service. We have determined that we would bill using 99080, but we are unsure about the charge amount. I have seen in some threads in the forum that $ 25 is allowed, however, one of our physicians has heard we can charge as much as $ 100 per visit. Does anyone know what is appropriate in Texas?

Thank you.

Medical Billing and Coding Forum

Nurse practitioner billing

Posted on by
Good morning,

Scenario: multi specialty practice, ONE tax ID.. Ortho and PM&R. When a patient sees an ortho, and then sees the PM&R within 3 years, the PM&R can bill a new patient visit because the PM&R is a different specialty, and vice versa.

Is a nurse practitioner considered a "different specialty" as well? Is she able to code her initial visits with patient who have already been seen by one of the orthos or PM&R in the last 3 years?

Thank you

Medical Billing and Coding Forum

Nurse practitioner billing

Posted on by
Good morning,

Scenario: multi specialty practice, ONE tax ID.. Ortho and PM&R. When a patient sees an ortho, and then sees the PM&R within 3 years, the PM&R can bill a new patient visit because the PM&R is a different specialty, and vice versa.

Is a nurse practitioner considered a "different specialty" as well? Is she able to code her initial visits with patient who have already been seen by one of the orthos or PM&R in the last 3 years?

Thank you

Medical Billing and Coding Forum

HPI done by nurse

Posted on by
We have a provider who’s nurse does the HPI and we were told that this is an acceptable practice, to just disregard the HPI (don’t count the History of present illness) when coding the E&M level and assigning level of care. I was taught that the HPI was to be done by the provider, and as a CPC should we not ask the provider to do the HPI, so we are following guidelines?

Feed back on this would be greatly appreciated.
Thanks!

Medical Billing and Coding Forum

Nurse Visit and Physician Visit on Same DOS

Posted on by
I have a nurse who provided instruction/education on medication self-injection for 40 minutes, and then afterwards the physician came in to evaluate an unrelated problem (look at something on lip). How would we charge for both of their time, since the nurse visit was unrelated to the physician visit? This is a Medicare patient.

Medical Billing and Coding Forum

Certified Nurse Midwife

Posted on by
Hi,

I have a Certified Nurse Midwife in our practice and she is still not credentialed to deliver babies in our local hospital. We have an on call provider from a different practice that is helping with our deliveries until she is credentialed. My question is how can I bill for the delivery for her since she will need a "supervising Provider" for the claim? Any help is appreciated.

Thanks,
Veronica

Medical Billing and Coding Forum