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62272 (pa)

Colleen25

Contributor
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20
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0
I've recently received a denial from NGS (Medicare) for procedure code 62272 that a PA performed on it's own. Does anyone know if a PA is allowed to perform that procedure on his/her own in the hospital without a physician on site? Thanks!
 

ARCPC9491

True Blue
Messages
700
Location
Stafford, VA
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I've recently received a denial from NGS (Medicare) for procedure code 62272 that a PA performed on it's own. Does anyone know if a PA is allowed to perform that procedure on his/her own in the hospital without a physician on site? Thanks!

It depends - is this service defined in the PA's scope of services? if your state approved it - you could use that to appeal the claim. (sometimes even though it's state approved, Medicare might not honor it, but worth a shot)

As long as the PA has the specialized training to perform the procedure, as defined in the scope of services, you should be ok.

Your PA has his/her own Medicare PTAN, right? What exactly did your denial say? Did you check your LCD's w/ your contractor?
 
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