Billing Code Update

Tuesday, June 30, 2020

North Carolina 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 updated codes are:

24546 (A)

25310 (A)

25447 (A)

27759 (A)

33390 (A)

34812 (A)

43774 (A)

44970 (A)

49568 (A)

62161 (A)

63655 (A)

63685 (A)

636707 (A)

96112

96113

96420

96420 (B)

96422

96422 (B)

96423

96423 (B)

96425

96425 (B)

96440

96440 (B)

96446

96446 (B)

96521

96521 (B)

96522

96522 (B)

97597

97597 (B)

97598

97598 (B)

 

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

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

The Medicaid website has a complete list of previously denied billing codes for NPs and PAs and the updates that were made to the codes.

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.

Contact

NCTracks Contact Center: 800-688-6696