Billing Code Update for Nurse Practitioners and Physician Assistants

Medicaid has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).

Medicaid has provided instructions to NCTracks on updating the claims processing system. The following procedure code list has been updated recently to include additional NP and PA taxonomies.

The newly added codes are:

• 11755
• 11755 (B)
• 20605 (B)
• 22551 (A)
• 36478
• 36478 (B)
• 37765
• 37765 (B)
• 50688
• 50688 (B)

Codes marked with an (A) were updated for modifiers 80 and 82

* Codes marked with a (B) were updated for modifier 59

Note: The following codes were updated:

• 11755, 36478, 37765 and 50688
• 22551 with modifiers 80 and 82
• 11755, 20605, 36478, 37765 and 50688 with modifier 59

The Medicaid website has a complete list of previously denied billing codes for NP, PAs and Certified Nurse Midwives.

Note: Codes currently in process for system updates will be published once system modifications are completed. New code problems will be addressed as NC Medicaid Clinical Policy becomes aware of them.