Wiki Non Physician Billing

[Pillow1]

Does a a non physician (nurse practioner) rendering services in a doctors office, need a supervising physician qualifier denoted on box 17?

(the nurse practioners NPI is entered on box 24J and Nurse practioners name is entered box 31)
PER CMS :for the CMS - 1500 The instructions effective 4/1/14 state:

Enter one of the following qualifiers as appropriate to identify the role that this physician (or non-physician practitioner) is performing:
Qualifier Provider Role
DN Referring Provider
DK Ordering Provider
DQ Supervising Provider
Enter the qualifier to the left of the dotted vertical line on item 17.

I know a non physician (Nurse Practioner)can be the referring or ordering but my question is does the nonphysician(NursePractioner) require a supervising qualifier DQ of the supervising physician in box 17 when it is not considered incident to ?

Thank you for any feedback.
__________________
Denise

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Last edited by Pillow1; Today at 04:16 PM. Reason: inadvertantly omitted a portion of the last sentence

 

[82750]

Box 24 J and Box 33 on HCFA

Hello,

If you are an independent physician or Lab is it required to have your NPI in both fields? We have a provider billing with no NPI in either fields and claims are being denied for missing NPI.

Thanks
Jenny

 

[CodingKing]

Box 17 is the referring physician (for instance PCP goes there if they referred to you as specialist office) i'm not aware of the Qualifiers , my understand is unless its incident to MD doesn't go anywhere on the claim.

 

[mitchellde]

The qualifiers are DN, DK and DQ. They indicate whether this is the referring provider, oerdering provider or supervising provider. You can find this explain in the instruction manual for the 1500. At www.nucc.org