Get a DRG grouping summary and IPPS payment calculation with your code search and crosswalks!Learn More

Ask an Expert

Answers to Compliance and Medical Coding Questions.
  1. Annmarie Posted 7 Year(s) agoRelated Topics

    looking for the correct way to code an NP. Have used 99214-AK and the Dr's NPI-commercial ins has paid but medicare denied stating incorrect modifier used. Do I need to bill using the NP's name & NPI for medicare? I cannot find any info on this, please help!
    Thank you

  2. SuperCoder Posted 7 Year(s) ago

    modifier AS: Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant-at-surgery, non-team member. Reimburses at the Non Physician practitioner rate of 85% of the Medicare Physician Fee Schedule, then Assistant at surgery rate of 16% of the calculated non physician practitioner rate.

    For Nurse practitioner rendering service in collaboration with the physician, then we need to use modifier SA.
    Modifier SB for Nurse midwife.
    Modifier UC for Clinical Nurse specialist.

  3. Annmarie Posted 7 Year(s) ago

    Thank you for your help!

About this Question

  • Posted by 19404 Annmarie, 7 Year(s) ago. There are 3 posts. The latest reply is from Annmarie.