Wiki Coding and Billing for a CNS in Pennsylvania.

[jlezinsky]

Does anyone have any knowledge of billing and coding for a Certified Nurse Specialist in Pennsylvania? Especially in a surgical setting.

 

[coloradopa]

Does anyone have any knowledge of billing and coding for a Certified Nurse Specialist in Pennsylvania? Especially in a surgical setting.

Looking at Pennsylvania law it doesn't look like CNS are recognized as ARNP in Pennsylvania. They don't have the authority to order tests or prescriptions so it doesn't appear that they are a covered entity.
CMS only allows CNS services if they are allowed by state law to provide services that are considered physician services if provided by an MD or DO. Here is the CMS guidance (starts on page 5):
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1734B3.pdf

Here is a matrix from the Hospital Association of Pennsylvania that covers CNS among other things:
http://pspa.net/wp-content/uploads/2014/04/HAP2013HospitalSettingMatrixFinal.pdf