Billing Code Update for Nurse Practitioners and Physician Assistants

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

NC 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 updated codes are:

Codes marked with an (A) were updated for modifiers 80 and 82; codes marked with a (B) were updated for 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 complete. New code problems will be addressed as NC Medicaid Clinical Policy becomes aware of them.

(MP 19.190, MP 19.218, MP 19.222 and MP 20.012)