Wiki New Audiologist


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We have an audiologist joining our one physician ENT/Allergy Immunology/Facial Plastics practice.

Am totally lost about credentialling/billing guidelines for audiologist services.

re: Medicare/audiologist billing, commercial carriers, etc.

Obviously I want to be compliant.

Any other coders out ther who have been "in my shoes"?
Check the CME website. There are new policies going into effect in October re: audiologist needing to have their own NPI #

Audiologists Billing Medicare

April 29, 2008

As of October 1, 2008, Audiologists must report their NPI on claims for diagnostic test services. Currently some audiologists are reporting under the physician's NPI rather than their own NPI.

On February 29, 2008, the Centers for Medicare and Medicaid Services (CMS) issued Change Request 5717 titled “Update to Audiology Policies”. Transmittal 1470 of that change request provided clarifications to the Medicare Claims Processing Manual (Pub. 100-02). In Pub 100-02, Chapter 12, Section 30.3, the manual instructions state, “. . . the audiologist's NPI is required on all claims for services furnished by audiologists.” Use of the NPI in the primary identifier field on a claim requires Medicare enrollment.

Note that CMS is instructing contractors to, prior to October 1, 2008, continue to process claims without the NPI of the audiologist. All other instructions in Change Request 5717 remain unchanged.

CMS will require the use of the NPI on claims for diagnostic test services furnished by audiologists on or after October 1, 2008. Audiologists are encouraged to obtain an NPI and enroll as soon as possible.