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Wiki SNF and NPPS

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kapral

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Can a NP admit to a SNF, I have gotten a few denials as not payable under Part B services, she is adding the A1 modifier and I have a feeling it is the modifier that is causing the issue, as the modifier instructions state "physician of record".
 
They cannot admit to a SNF. I suggest reading your local coverage determination from your carrier. My carrier is Novitas - here's a link to the policy if you'd like to take a look at it-
https://www.novitas-solutions.com/policy/mac-ab/l27496-r7.html

They can perform consults in a SNF and do follow up/progress notes. If you are being denied for consults in a SNF appeal them. I have personal experience with RR Medicare denying consults for NPP's in the SNF. If you ever have an issue there reference MLN Matters Article 6740 and 7405. I have appealed to 2nd level QIC and won every one of them.
Good Luck!
 
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