Billing Code Update (February 2019)

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

Medicaid has provided instructions to NCTracks and the following procedure code list has been updated recently to include additional NP and PA taxonomies. The newly added codes are: 

* 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:

20220, 32552, 35226, 38222, 42400

27091, 29827, 32651, 35226, 43279, 43282, 50543 and 63267 with modifiers 80 and 82

10160, 20220, 32552, 35226, 36569, 38222, 42400 with modifier 59

The Medicaid website has a complete list of previously denied billing codes for NPs, 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 Medicaid Clinical Policy becomes aware of them.

(MP 19.056, MP 19.065, MP 19.073, MP 19.076, MP 19.111, MP 19.112, MP 19.114)