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Annmarie Posted 7 Year(s) ago

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

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.

Annmarie Posted 7 Year(s) ago

Thank you for your help!

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

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