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Wiki nurse practitioners

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cward267

cward267

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I received this from another coder and would like to know if anyone has any insight on this? Any links to this in writing?

*I found out something interesting yesterday. I had a new patient office visit deny by Medicare since the patient had previously had a new patient visit in the Care Center by one of their nurse practitioners. My ortho claim was also for a nurse practitioner visit and the Medicare rep told me their system classifies NP's as non specialty regardless of the doctor/clinic they work in. So I have to appeal with documentation. *

Thanks so much!
 
They are correct . You cannot have 2 new patient encounters in the same office within the 3years. Also within the same specialty., and since NPs are considered nonspecialists , once attended to by one NP they are established for all others.
 
visits

Hello,
one was in the Care Center and the other in the Orthopedic office , not the same office or NP?? I think it's the same hospital campus....

Thank for the help.
 
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