Wiki Billing for CRNFA

[danielawhit]

My boss has asked me about how to capture billing for the Certified Registered Nurse First Assist. I understand that State to State billing is slightly different and I am in Mississippi. From what I am gathering from reserching we would need to get the Nurse a NPI number and everything and bill with an AS modifier? I know the modifier kind of depends on the insurance carrier but I am wondering if anyone knows where I could find more information on this subject?

 

[em2177]

RNFA billing guidelines for surgical assists

Registered nurse first assistants (RNFAs) are eligible for reimbursement when providing surgical assist services for surgeries that justify an assist. Eligibility for reimbursement is applicable to all products, unless a procedure is not covered under a contract or benefit plan.

The allowance for RNFAs? services is based on 20 percent of the global surgical procedure?s allowed amount, or the assist charge, whichever is less. For multiple or bilateral surgical procedures, reimbursement cannot exceed 20 percent of the surgeon?s total allowance.

Bill an RNFA surgical assistant procedure using the AS modifier. Do not use modifiers 80, 81 and 82 for RNFA services; these modifiers are applicable only when the surgical assist is by a physician.

For claim(s) received for processing, we need the following information:
?
Service date

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Five-digit surgical procedure code

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Modifier code (AS)

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Billed amount

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Provider number


Payment is issued to the provider entered in block 33 of the claim form. When billing for surgical assistant procedures performed by an employed RNFA, use the physician?s provider number.

 

[danielawhit]

Thank you SO MUCH! I really appreciate your answer!

 

[Sarie24]

Billing for RNFA

Hello!

I wanted to confirm that we can bill for RNFA's on a CMS-1500. I was researching online and heard the CMS-1500 mentioned but it's hospital billing so I wanted to double check.

I welcome any input! Thank you!

Sarah