Wiki Medicare CPT Codes Allowed by PA

[sxcoder1]

Is there a way to tell if Medicare will pay for a CPT code done solely by a physician assistant? We tried billing cpt 54220, irrigation of corpora cavernosa for priapism, done by a PA in the ER, but Medicare is denying because it was done by a PA. Thank you for any information!

 

[eberra]

This is generally determined by the state scope of practice. If you believe your state allows a PA to perform this service, then appeal the denial with the information from the state. In the appeal request they take the question to the contractor medical director.

 

[amyjph]

Agree. State scope dictates.

 

[sxcoder1]

Great, thank you!