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06/24/2010

The number of non-physician practitioners (NPPs) participating in Medicare has risen steadily over the last four years, growing at nearly four times the rate of physicians, an NPP Report analysis of CMS enrollment data shows. From 2006 to 2009, the number of nurse practitioners (NPs) and physician assistants (PAs) enrolled in Medicare increased by 7.5% and 7.2% respectively, compared to an average of 2.2% for physicians across all specialties.

06/24/2010

This week's question is answered by Regan Bode, CPC, CPC-H, CPMA, CEMC, ACS-EM, content manager for DecisionHealth and consultant for DecisionHealth Professional Services.  

Q: I have a radiologist who specializes in mammography and she is the director of breast imaging at a free standing facility in New Jersey. The company would like to offer genetic counseling when necessary. Licensure has been approved, but we don't have a license in place at the moment. Genetic counselors get NPI numbers. Is it possible to bill the service as an E/M under the radiologist, if she is present and has an order from the gynecologist for genetic counseling? Or does the genetic counselor bill 96040 under her name and NPI? 

06/24/2010

Summary: This chart examines denials from a per-provider angle, looking at how the major non-physician practitioner (NPP) specialties fare when it comes to denials and the revenue they cost. NOTE: The number of denials is an average, calculated by dividing the number of denials into the number of providers enrolled in each specialty. The dollar cost of denials is also an average, derived from the average payment to each specialty, multiplied by the number of denials per provider. Denials are an average of denials for all codes billed in 2008.

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