Sheryl;
Questions about coding and billing for services come up on these list serv communities so often! It would be so helpful to have a CPC consultant for the AAACN.
Even if a code exists for a service and the definition of the code indicates that an RN who is not a QPP (i.e., NP, CNS, CNM) can provide said service, reimbursement for that service depends on the contract the organization has with the payer (the patient's insurance).
Those who pay the bills make the rules.
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Leslie McDowell ANP-BC DNP RN
QI Specialist / Curriculum Developer
Northwest AHEC / Wake Forest University School of Medicine
Winston Salem NC
(336)972-7852
ANP-BC DNP RN
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Original Message:
Sent: 07-27-2023 18:00
From: Sheryl Bartlett
Subject: Billing for Telephone Triage Nursing Care
I wanted to reach out to see if any organizations are billing for telephone triage that their Registered Nurses are providing through insurance.
I know some programs bill provider groups for services and others are supported by the organization or health system as a patient quality/safety program financially absorbed by the system.
At this year's conference, there was some discussion about billing under a CPT code if the triage nurse was providing education to the patient (which we do with every encounter really).
I just wanted to see if anyone has found an avenue that can capture revenue for this patient care that the nurses are delivering.
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Sheryl Bartlett BSN RN
Nurse Manager After Hours Triage
UT Southwestern -Clements University Hospital
Dallas TX
(214)563-1120
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