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Mid Level Provider Billing

Chris Posted Tue 03rd of September, 2019 16:44:36 PM
When an MD is out of the office, but a mid-level oversees testing for a test such as a stress test (93015) or stress echo(93351), is there an appropriate way to code for the technical component such as using modifier SA and TC while using the MD NPI as the rendering in an outpatient facility or is it more correct to un-bundle and use only the SA modifier. For example, is it appropriate to bill 93015 SA:TC and 93015 26 or is it more appropriate to bill 93016 SA, 93017 SA and 93018 using the MD NPI since SA signifies the MD is billing on behalf of a mid-level.
SuperCoder Answered Wed 04th of September, 2019 07:34:24 AM
Hi nbsp You don't have to attach modifier - Professional component or nbsp -TC Technical component to cardiac stress test codes - because the CPT descriptors break out the components nbsp Use the definitions below to note which codes represent the professional technical or global components CPT - Cardiovascular stress...
Chris Posted Wed 04th of September, 2019 12:02:23 PM
In reading your reply the first article states that you must bill under the NPP NPI so that would mean that modifier SA could not be used and could not bill under the supervising MD NPI when billing Medicare correct Also just to clarify in an office outpatient setting where...
SuperCoder Answered Thu 05th of September, 2019 08:58:00 AM
Hi nbsp You should use HCPCS Level II modifier SA Nurse practitioner rendering service in collaboration with a physician for supervised nurse practitioner services when the insurer does require this modifier Some Medicaid programs such as Medi-Cal require you to apply modifier SA to all nurse practitioner NP services which...

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