Author Topic: who's NPI for a nurse practitioner charge....help !?  (Read 4023 times)

spinalhealth

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who's NPI for a nurse practitioner charge....help !?
« on: February 06, 2012, 09:48:10 AM »
I work in a multi-specialty clinic (chiropractic, primary care, pain treatment, massage and physical therapy) and we have two nurse practitioners.   They see patients as their primary care and for pain treatment, they are supervised by an MD.  Here are my questions:  Who's NPI number needs to go on the claim ?  Does the MD's NPI go in box 17a or b since he's the supervising physician?  And would the FNP's NPI go in box 24J or the MD's ?

I'm at a loss here -- I've got a few guesstimates, but want and need to make sure I set this up correctly.

I would appreciate ANY information....

THANK YOU ! :)

Michele

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Re: who's NPI for a nurse practitioner charge....help !?
« Reply #1 on: February 06, 2012, 01:55:52 PM »
24J is supposed to be the NPI of the person who rendered the service.  Some insurance carriers do not recognize or credential the FNP's so in that case you would use the supervising physician's NPI.  If the insurance carrier does recognize and/or credential FNP's then you should be using the FNP's NPI in 24J.  17A is for the ordering or referring physician, not the supervising.

Hope that helps!
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spinalhealth

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Re: who's NPI for a nurse practitioner charge....help !?
« Reply #2 on: February 07, 2012, 08:58:50 AM »
thanks michele --

ok - just so i'm sure (never had to set up nurse practitioners / pain managment billing).....

box 17 is referring physician's name ((CAN THAT BE LEFT BLANK IF IT'S AN "IN-HOUSE" REFERRAL?))
box 17A is referring physician's __________________ (tax id#, mdcr# ????)
box 17B is referring physician's NPI number ??

box 24J is the nurse practitioner's NPI only if the insurance company recognizes and credentialed them and the MD's NPI otherwise.....
box 32 a AND b --- our group npi or individual?
box 33 a AND b --- our group npi or individual?

i appreciate the help :)
Jennifer

Michele

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Re: who's NPI for a nurse practitioner charge....help !?
« Reply #3 on: February 14, 2012, 10:45:26 AM »

box 17 is referring physician's name ((CAN THAT BE LEFT BLANK IF IT'S AN "IN-HOUSE" REFERRAL?))      Yes
box 17A is referring physician's __________________ (tax id#, mdcr# ????)            Blank
box 17B is referring physician's NPI number ??   Yes

box 24J is the nurse practitioner's NPI only if the insurance company recognizes and credentialed them and the MD's NPI otherwise.....    Otherwise supervising physician
box 32 a AND b --- our group npi or individual?          32a is group NPI, b is blank
box 33 a AND b --- our group npi or individual?           33a is group NPI, b is blank

i appreciate the help :)
Jennifer
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