# RNFA Billing-at a complete loss



## AR2728 (Dec 20, 2011)

Our RN recently receieved RNFA certification, she will begin assisting our general surgeon and OBGYN during surgeries.  I'm at a complete loss for where to begin billing for an RNFA.  I'm unsure what modifier to use, what information needs to be provided in the operative note, if we bill under the surgeons NPI, and if we adjust the fee to represent the RNFA's portion or we bill out the full surgery fee......Assitance would be greatly appreciated.  At this point, I don't even know where to begin.  I've researched the internet and forums and found conflicting or no information.


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## ajs (Dec 20, 2011)

AR2728 said:


> Our RN recently receieved RNFA certification, she will begin assisting our general surgeon and OBGYN during surgeries.  I'm at a complete loss for where to begin billing for an RNFA.  I'm unsure what modifier to use, what information needs to be provided in the operative note, if we bill under the surgeons NPI, and if we adjust the fee to represent the RNFA's portion or we bill out the full surgery fee......Assitance would be greatly appreciated.  At this point, I don't even know where to begin.  I've researched the internet and forums and found conflicting or no information.



I believe you bill their services with an AS modifier to indicate they are a non-physician provider of service.  The operative note just needs to state the name and credential of the assistant the same as when a physician is the assistant surgeon.  I also believe you need to apply for an NPI number for the RNFA provider so she can bill under her own number.  I found a lot of this information on a Blue Cross Blue Shield website.  Not all insurance carriers recognize the non-physician practitioner, so it would be best to check with your main insurance carriers before starting to bill out these assists.


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