Gastroenterology Coding Alert

Question: One of our gastroenterologists will be away for ten weeks. He has made locum tenens arrangements for another gastroenterologist of our group to cover while he’s away. There already is a nurse practitioner who bills incident-to under the gastroenterologist who will be away. How do we bill the NP’s services while the locum tenens gastroenterologist is supervising?

Dallas Subscriber

Answer: Incident-to requirements state that the supervising gastroenterologist doesn’t have to be the gastroenterologist who is associated with the plan of service. Any gastroenterologist can supervise, as long as the NP is acting as an extension of the plan created by your gastroenterologist.

Documentation: For example, the NP is providing incident-to services based on Dr. A’s plan. Dr. B is the locum tenens gastroenterologist during Dr. A’s absence. File the claim with Dr. A’s name and identification numbers, with modifier Q6 (Service furnished by a locum tenens physician) to indicate a locum tenens gastroenterologist was present instead of Dr. A. The supervising gastroenterologist is the locum, but his name won’t actually be included on the claim.

Note: Effective April 1, 2013, the NPI of the locum will also need to be included on the claim. See the one-time notification from CMS online at http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1151OTN.pdf .