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Posted By Danielle Levy on 08-08-2019, 08:30:02 in Ob-Gyn
Melanie,
Good morning, We have a group of OB/GYN'S who have 10 certified nurse midwives that sees patients in the office and also assist with C-sections . Would the correct coding for the delivery be 59515(80) or would we bill 59515( AS) for Medicaid ? would we bill 59514(80) or 59514( AS) for commercial insurance ? Also would we bill the nurse midwife as the supervising / rendering and billing physician or would we bill incidental to the physician ? Any input would be helpful and appreciated . Thanks in advance
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Posted By Melanie Witt on 08-20-2019, 19:19:37
I ended up answering this off the forum but will repost my answer for those who might also be interested: You should not be billing a 80 modifier for a NP assisting no matter who you are billing unless you have been specifically instructed to do so by a specfic payer. 80 is reserved for a physician so please stop doing what you are doing. The AS modifier (Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery) is the only approved modifier to report this. This is because the payer needs to know how much to reimburse - the NP gets paid less. You never change the rendering/billing person to an MD if an NP did the service - that you be submitting a false claim. If they do not cover the services of an NP in this capacity you cannot use her to do it nor get paid. Also note that a CNM would fall under the category of clinical nurse specialist for billing purposes.
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