Wiki DN, DK and DQ Qualifier/Indicator Reporting

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Amie Anderson

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It looks like there are more and more things popping up about reporting the DN, DK and DQ Qualifier/Indicators on the CMS-1500 Form in box 17a/17b, but I am not finding anything specific that gives a clear explanation on who, how or when this is required and my Practice Manager is wanting to know if this is something that is only SNF/Facility specific or if this is something that needs to be reported on Part B Provider Claims too!? If anyone has knowledge or information regarding this - any and all information would be greatly appreciated. Thanks in advance!
 
They are for use on provider claims any time you use a provider name in field 17 you must use one of these qualifiers it indicate referring provider, supervising provider, or ordering provider.
 
This conversation just came up in my office yesterday. We are a surgical office. Patients get reffered to us DN, Then we can send them to get more tests, DK, Or we supervise their care. DQ (aneurysms) So will this change every time we send out a claim? For E/M or Surgery?
 
What exactly is meant by supervising physician? Used for NPPs? Used if TC only is reported? The Attending?
 
Has anyone received any clarification to this issue? We are trying to figure out how to populate 17a/17b on the new 1500 form. For instance we are an Endocrinology practice and we have NP/PAs in our office. Currently we use referring physician option on our all of our claims for services that we have done in our office (such as labs, ultrasounds, FNAs, etc) as there has never been any other options available before now. We also use the physician as the referring for "incident to" services however now it appears that the supervising qualifier will need to be selected from now forward if I am reading it correctly. Does anyone have any clarification on this new process? Would we use the referring qualifier for the labs, FNAs, and Ultrasounds) or should we use the qualifier for ordering? Also in the instance of incident to services are we now to identify those by choosing the supervising qualifier? Any feedback is appreciated.

Michelle
 
DN vs DK Qualifier

Can anyone help with this question?

It appears our system hard-codes the DN qualifier which is referring providers for the old form. With the new form, the treating provider is the same as the ordering provider for radiology services. The same information populates in the fields on the form however the Qualifier would need to be DK, which we are having a problem with. Our system is not set-up to correct the qualifier.

Then I ran across this statement:
The terms "ordered" "referred" and "certified" are often used interchangeably within the health care industry. Since it would be cumbersome to be technically correct, CMS will continue to use the term "ordered/referred" in materials directed to a broad provider audience. http://www.cms.gov/Outreach-and-Edu...k-MLN/MLNMattersArticles/Downloads/SE1305.pdf

Does it matter which qualifier is used? Any advice would be appreciated.
 
Which qualifier is used for "incident to" billing?

My practice manager has also requested that I find out which qualifier is the correct one to use when filing "incident to" services for a NP that was recently hired. I've never billed "incident to" and haven't been able to find a straightforward answer to this question. If anyone has the answer to this question, it would be greatly appreciated. Thanks
 
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