Wiki Workers Comp Claim

[amoore2986]

Does anyone know anything about coding workers comp claims in Kansas? I have a claim that has denied stating I need a modifier on the office visit. My provider is a PA. The only other procedure codes I have are an x-ray and DME. I have already tried a -25 (even though I knew it was not correct) and it still denied. I have no idea what the payer wants. Any help would be appreciated.

 

[josephmglick]

I would try the NP modifier per the Kansas Work Comp Fee Schedule, E/M Services Ground Rules bullet #8

8. BILLS SUBMITTED BY NON-PHYSICIAN PROVIDERS: Bills for E/M services provided by non-physicians such as
physician assistants or advanced practice nurses must be submitted on the CMS 1500 form or an equivalent form
containing the same information. Payment for these services will be limited to 85% of the maximum allowable fee
associated with the CPT code (plus –NP modifier) submitted. The 15% discount is not applicable to any related
laboratory or medical supply charges. This form must also clearly identify the responsible physician.

 

[RyanRaichCPC]

Hello,

I agree with the above poster. We bill work comp in Kansas and have to append -NP to all of our PA claims.