There is some news in the long-running saga of CPT codes closed to PAs and NPs since the NCTracks Medicaid claims system for North Carolina went live in July 2013.
The Department of Medical Assistance (DMA) announced 66 more codes open for billing by Physician Assistants (PA) and Nurse Practitioners (NP). DMA’s posted chart incorporates these newly-opened codes into the list of codes previously opened in February. For your convenience, NCMS isolated the new codes and created the below chart. Newly added codes include many E&M services and injections/infusions.
As DMA opens codes to PAs and NPs, the updates to the codes should be retroactive to July 1, 2013. But you must resubmit claims for these services in order to get them paid. Medicaid IS NOT reprocessing claims automatically.
At the urging of NCMS, both DMA and CSC, the company administering NCTracks, have pledged to improve how they communicate the status of codes they are reviewing for PAs and NPs. They have recognized much of providers’ frustration is because it’s not known where this ongoing process stands. Be on the lookout for more messages from them about this. This is subject to change, but here’s a glimpse of what they have in mind:
DMA plans to draft a biweekly communication article that should address the communication issue discussed earlier today. High level, DMA will instruct NCTracks to publish a biweekly article through NCTracks such as every other Monday. The article will have the status on codes that DMA received /under review AND acceptance or denial on codes. The codes accepted or denied will then be removed from the biweekly publication and submitted for the next month Medicaid bulletin. These codes will be published one time in the Medicaid Bulletin.
NP/PA Codes Announced May 2015 | |||
22325* | 22633 | 96367 | 99241 |
22326* | 22634 | 96372 | 99242 |
22327* | 22802* | 96374 | 99244 |
22328* | 22804* | 96375 | 99245 |
22532* | 22843* | 96415 | 99291 |
22533* | 22845 | 96417 | 99292 |
22534* | 27245 | 96523 | 99304 |
22548* | 27269* | 99170 | 99305 |
22552* | 61070 | 99217 | 99306 |
22554* | 61154 | 99218 | 99355 |
22556* | 62252 | 99220 | J2270 |
22558* | 63045* | 99222 | J2469 |
22560* | 63281 | 99223 | * open to modifiers 80 and 82 only |
22595* | 63709* | 99234 | |
22600* | 64721 | 99235 | |
22610* | 82728 | 99236 | |
22612* | 83550 | 99238 | |
22630* | 96366 | 99239 |