More Codes Open for Billing by PAs and NPs in NCTracks

There is some news in the long-running saga of CPT codes closed to PAs and NPs since the NCTracks Medicaid claims system for North Carolina went live in July 2013.

The Department of Medical Assistance (DMA) announced 66 more codes open for billing by Physician Assistants (PA) and Nurse Practitioners (NP). DMA’s posted chart incorporates these newly-opened codes into the list of codes previously opened in February. For your convenience, NCMS isolated the new codes and created the below chart. Newly added codes include many E&M services and injections/infusions.

As DMA opens codes to PAs and NPs, the updates to the codes should be retroactive to July 1, 2013. But you must resubmit claims for these services in order to get them paid. Medicaid IS NOT reprocessing claims automatically.

At the urging of NCMS, both DMA and CSC, the company administering NCTracks, have pledged to improve how they communicate the status of codes they are reviewing for PAs and NPs. They have recognized much of providers’ frustration is because it’s not known where this ongoing process stands. Be on the lookout for more messages from them about this. This is subject to change, but here’s a glimpse of what they have in mind:

 DMA plans to draft a biweekly communication article that should address the communication issue discussed earlier today. High level, DMA will instruct NCTracks to publish a biweekly article through NCTracks such as every other Monday. The article will have the status on codes that DMA received /under review AND acceptance or denial on codes. The codes accepted or denied will then be removed from the biweekly publication and submitted for the next month Medicaid bulletin. These codes will be published one time in the Medicaid Bulletin.

 

NP/PA Codes Announced May 2015
22325* 22633 96367 99241
22326* 22634 96372 99242
22327* 22802* 96374 99244
22328* 22804* 96375 99245
22532* 22843* 96415 99291
22533* 22845 96417 99292
22534* 27245 96523 99304
22548* 27269* 99170 99305
22552* 61070 99217 99306
22554* 61154 99218 99355
22556* 62252 99220 J2270
22558* 63045* 99222 J2469
22560* 63281 99223 * open to modifiers 80 and 82 only
22595* 63709* 99234
22600* 64721 99235
22610* 82728 99236
22612* 83550 99238
22630* 96366 99239

 

 
 

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