Attention: Nurse Practitioners and Physicians Assistants Billing Code Update for Nurse Practitioners and Physician Assistants

Since the transition to NCTracks, the N.C. Division of Medical Assistance (DMA) has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).

DMA has provided instruction to NCTracks on updating the claims processing system. The following procedure code list has been updated to include additional NP and PA taxonomies. Codes currently in process for system updates will be published once system modifications are completed. New code problems will be addressed as DMA Clinical Policy becomes aware of them.

 

11000

11001

11301

11302

11305

11310

11900

11901

12032

16030

17000

17003

17004

17110

20206

20501

20551**

20611*

23350

23412*

25606***

27130*

27310*

27370

29065

29075

29345

29355

31515

32555

32557

36005

36010

36147

36148

36556

36568

36580

36584

36620

37191

38505

40490

47505

49180

49418

49423

49424

50387

50389

50390

50392

50393

50394

50398

51600

57456

57500

58100

61312*

61320*

62284

62290

62368

62370

63056*

63300*

63300***

63308*

66405

64400

64445

69100

69210

75902

76817

76882

77001

77003

82670

83014

83690

84100

86003

86706

86800

87101

87490

87590

92025

93279

93280

93285

93286

93287

93288

93289

93290

93291

93292

93293

93750

94640

94642

94664

95970

95974

95978

95991

96111

96450

96567

96920

99143

99144

99145

99148

99149

99150

99183

99201

99203

99211

99213

J7324

 

 

 

Note:          

  • Codes marked with 1 asterisk (*) were updated for modifiers 80 and 82 only
  • Codes marked with 2 asterisks (**) were updated for modifier 59 only
  • Codes marked with 3 asterisks (***) were updated for modifier 55 only