Orthopedic Coding Alert

Question: One of our orthopedists was on call at the ED, and the ED physician requested an orthopedic consult. The orthopedic resident on call saw the patient on behalf of the physician who was on call. The resident treated the patient and referred him to our office for follow-up care. Can I bill for the residents services using my orthopedists PIN?

New York Subscriber

 
Answer: Services rendered by a resident at a teaching facility when the supervising physician is not present for the key elements of the encounter should never be reported. Go to www.hcfa.gov/pubforms/14_car/3b15000.htm#_1_8 for the section of  the Medicare Carriers Manual that addresses the services of supervising physicians in teaching settings. You will find this statement: Pay for physician services furnished in teaching settings under the physician fee schedule only if the services are personally furnished by a physician who is not a resident; or the services are furnished jointly by a teaching physician and resident or by a resident in the presence of a teaching physician with certain exceptions as provided below. Under the circumstances you describe, your physician should not report a consultation code.