Ob-Gyn Coding Alert

Reader Question:

Find Out What Services a CNM Can Perform

Question: BCBS has denied a claim stating that our certified nurse midwife (CNM) cannot perform a 11200 or 56501. We don’t think this is correct, but we can’t find anything about what CNMs may not be allowed to perform in office. What should we do?

Alabama Subscriber

Answer: First, you need to check with this payer’s policies regarding CNM privileges and also with your state practice act for a CNM on what procedures that are allowed to perform. If she is also a nurse practitioner (NP), she can probably do office procedures, but some payers do confine services of a CNM to obstetrics only.