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ARNP and Non-privileged versus privileged providers

  1. #1
    Everett, WA
    Default ARNP and Non-privileged versus privileged providers
    Medical Coding Books
    Can anyone offer some guidance? ARNP wants to know if she can compliantly bill for the telephone codes of 99441-99443 rather than the non-physician codes of 98966-68. My initial response was to think "no" as the non-physician codes are provided for that reason. However in my research have found that this may be carrier specific depending on the "scope of practice", etc, etc. How does MCR handle this, too? We're tripping over the "terminology" and turning to my colleagues for help. If it is carrier specific, guess 'd best be on the phone calling our carriers (31 in fact!).

    Suzanne E. Byrum CPC

  2. #2
    Columbia, MO
    If your ARPN can bill 99201-99215 levels then they use the provider levels. The 98966-69 are for other qualified healthcare personnel such as nurses and counselors.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Everett, WA
    Thanks Debra...the defnitition of "non-Face-to-Face" services includes codes to be reported by the "qualified healthcare profession". I thought this would include an ARNP, but your comment shows I might be in error. The terminology has not only confused me, but the ARNP as well. The followup question is now "what a privileged provider is defined by and if the ARNP needs to be this?" It's the terminology of "privileged" versus "non-privileged". What is meant by that? ---Suzanne

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