Forum - Questions & Answers

Jun 8th, 2009 - medcoder

Nurse Practitioner

Can maternal fetal medicine nurse practitioner's bill for consults? ( I say yes)

Nurse practitioner's receives questions all the time from OB patients who may or may not be in the maternal fetal medicine practice about blood sugar levels. She gives feedback on when to adjust insulin levels and when to call in with another blood sugar reading. Can patients be referred to her for a consult (billable), then charged for the phone advice?

I am not that familiar with OB coding so any help would be appreciated.

Medcoder



Jun 9th, 2009 - Codapedia Editor 1,399 

Nurse Practitioner

Here's an article that addresses this question.

http://www.codapedia.com/~article_222_.cfm

And a few more related ones:

http://www.codapedia.com/~article_356_.cfm

http://www.codapedia.com/~article_254_.cfm

Jun 9th, 2009 -

I need more info

Is the NP in another practice as the patient's OB? If she is providing OB care along with the doc, it is not a consult.
Who is "referring" for the consult? If the patient self-refers, it is not a consult. If another practice is "referring" the patient for advice on DM management, then it is a consult.

Jun 9th, 2009 -

Nurse Practitioner

Different type of situation- we have a clinic/hospital. The nurse practitioner's and provider used to work with the clinic and now have become part of the hospital. The patient's asking the questions are from the clinic setting. I need to asked if the patient's are self referring and just want a question answered ( hence the question about charging for a phone call) She does provide OB care with the provider. I expect each situation could be different based on what you have stated. Could she charge for a phone call if the clinic provider told the patient to call the nurse practitioner for DM advice?

I love this website- I appreciate everyone who participates.

Medcoder

Jun 10th, 2009 -

What a mess

I don't understand your situation- who works for whom but nonetheless you can bill for phone calls any time but you will likely not get paid. First OB is usually a global package and second most payors don't pay for them. And certainly your first contact must be face-to-face to establish a relationship before you can bill a phone call

Jun 12th, 2009 - Codapedia Editor 1,399 

Np

It is not clear:

Who pays the NP?
Who pays the MD?
Are they in the same group?
How are the patients getting to the NP: self referred, overflow from MD, from PCP's?

I don't think we can be helpful without more detail.



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