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Modifier AS - clinical nurse specialist

  1. #1
    Exclamation Modifier AS - clinical nurse specialist
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    Hello,

    I need some help with what is defined as a "clinical nurse specialist". I am in Washington state and keep getting denials from Regence saying that our surgery assistants are not qualified to bill for a surgery assist. They are nurses, but do not have any sort of special surgical assist certifications.
    Medicare recognizes physician assistants, nurse pratitioners, and clinical nurse specialists as NPPs with independent billing rights.

    Any help on this matter would be appreciated.

    Thank you!

  2. #2
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    Quote Originally Posted by marylehman View Post
    Hello,

    I need some help with what is defined as a "clinical nurse specialist". I am in Washington state and keep getting denials from Regence saying that our surgery assistants are not qualified to bill for a surgery assist. They are nurses, but do not have any sort of special surgical assist certifications.
    Medicare recognizes physician assistants, nurse pratitioners, and clinical nurse specialists as NPPs with independent billing rights.

    Any help on this matter would be appreciated.

    Thank you!
    I am by nooooooo means an expert on this subject....but I believe your state dictates what NPP is allowed to do...I think they all have to be certified in the state they are working/billing and state regulations dictate what services they are allowed to perform....maybe look at your LCD's on the subject or maybe your state medical society could help you...BUT... your "clinical nurse specialist" should know what he/she are and are not allowed to do.??

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