Pediatric Coding Alert

CPT doesn't offer the final word

The Reader Question "NPs Can Use MD Codes" in Pediatric Coding Alert Vol. 10, No. 12 indicates that nurse practitioners (NPs) can use codes that CPT 2008 designates as physician-only codes, such as 99441-99443, 90465-90468 and 99367. But before you do so, check your state laws.

"While the answer (could be) technically correct in certain states, that can only be determined by state scope- of-practice laws, not by CPT," says Linda Walsh, director of the American Academy of Pediatrics (AAP) Division of Health Care Finance & Quality Improvement and Committee on Coding and Nomenclature manager.

While you're checking if NPs in your state are eligible to use "physician" codes, find out who can use the nonphysician versions of these codes. Will they apply to psychologists, registered nurses, physical therapists, and occupational therapists? Once again, "use will depend on state scope-of-practice acts and payer policy," say Jeffrey Linzer Sr., MD, FAAP, and Linda Edwards, CPC, in the AAP Georgia Chapter's 2007 Coding Meeting.