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Effective January 1, 2010, Blue Cross & Blue Shield of Mississippi (BCBSMS) is revising the Nurse & Physician Assistants as Surgical Assistants Coding Policy to distinctly identify non-physician (non-MD, DO) assistants at surgery. Currently, covered non-physician assistants at surgery include Physician Assistants, Nurse Practitioners, and Certified Registered Nurse First Assistants (CRNFA). Beginning January 1, 2010, these covered non-physician assistants at surgery will be expanded to include Registered Nurse First Assistants with CNOR certification (RNFA). This policy change will apply to all lines of business, including the State and School Employees' Health Insurance Plan and the Federal Employee Program. Some self-funded groups may not cover non-physician assistants at surgery; please verify benefits prior to performing services to ensure your patient’s policy covers non-physician assistants at surgery.
In order to distinctly identify non-physician assistants at surgery, BCBSMS will be requiring that all assistants at surgery be credentialed for network participation. We currently have networks for Physician Assistants and Nurse Practitioners; however, we are expanding our networks to include CRNFAs and RNFAs with CNOR certification. If your assistant surgeon chooses not to be credentialed for network participation, it will still be necessary that they obtain a provider number in order to file claims. Please note that payment for services related to non-network assistant surgeons will be made to the patient.
Additionally, for dates of service January 1, 2010 and after, all assistant surgeons, including non-physician assistants, must file a separate claim for assisting at surgery under their unique National Provider Identifier (NPI) number. An ‘AS’ modifier is required when filing for a non-physician (non-MD or DO) assistant at surgery. Claims filed with the ‘AS’ modifier on the primary surgeon’s claim will not be accepted.
Click here to view the revised Nurse & Physician Assistants as Surgical Assistants coding policy.
If you have any of these provider types working with your surgeons to assist at surgery, it is important that they be credentialed for network participation immediately. A letter was sent to all surgical providers informing them of this policy change. If you have not completed and returned the forms included with this letter, it is very important that you return these forms immediately so the credentialing process can be finalized by December 31, 2009. If you did not receive the credentialing forms or have questions regarding the credentialing forms, please contact the Provider Administration Department at 601-664-4618.
Providers who have not applied for an NPI can apply through the web-based National Plan and Provider Enumeration System (NPPES) at https://nppes.cms.hhs.gov/, or by calling 1-800-465-3203 and requesting a paper application.