ED Coding and Reimbursement Alert

Question: One of our ED physicians went on maternity leave, and we hired a substitute to fill in for her. Yesterday, the substitute physician performed simple incision and drainage (I & D) on a carbuncle on a Medicare patients lower back. How do I code for this? Washington, D.C. Subscriber Answer: Medicare refers to this type of substitute physician as locum tenens; you might employ one if an ED physician takes an extended leave of absence. Remember to append modifier Q6 (Service furnished by a locum tenens physician) to any services the substitute physician provides to Medicare patients. For private payers, call and check to see if they observe the Q6 modifier policies differ depending on the insurer. For this claim, report 10060 (Incision and drainage of abscess [e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia]; simple or single]) for the I&D with modifier Q6 appended [...]