Part B Insider (Multispecialty) Coding Alert

Published on Sat Apr 15, 2006 PDF

Doctors can't be sued for emergency care to other doctors' patients

When you apply for a national provider identifier (NPI), you should include your old identification   numbers for other payors--not just for Medicare.

This will help payors to develop "crosswalks" between your old number and your NPI. If you include a Medicaid number, make sure you list the state name as well, the Centers for Medicare & Medicaid Services advises in an April 7 email to providers. 
In other news:

• There's not enough evidence to prove that Nesiritide is medically necessary for chronic heart-failure patients, CMS says in Change Request 4312, dated April 7. So Medicare will deny claims for Nesiritide for dates of service on or after March 2. It remains up to the carrier whether to cover other uses of Nesiritide.

• CMS issued an interim final rule on training for medical residents in areas affected by natural disasters such as Hurricane Katrina. If a "home hospital" temporarily closes parts of its residency programs, a "host hospital" can accept the residents. Medicare will continue to fund those residents in their new programs. Hospitals will be able to set up emergency graduate medical education (GME) agreements that are more flexible than usual GME agreements.

• Miami physician Zabdy Westerburger pled guilty to conspiracy and tax evasion, and faces up to 10 years' imprisonment, prosecutors announced. She allegedly agreed to provide bogus prescriptions in return for cash payments. Medical equipment companies would bring patients to Westerburger's office and she'd prescribe medical equipment whether it was necessary or not. The companies paid her between $50 and $200 per patient, depending on the reimbursement for the items she prescribed. Medicare paid for more than $2.3 million in unnecessary equipment and medications as a result.

• A doctor who responds to an emergency and treats another doctor's patient in the hospital is protected from medical liability under the "Good Samaritan" statute, the California Court of Appeals for the Fourth District ruled in Covarrubias v. Kady (D046529).

Tarek Kady wasn't the doctor in charge of the delivery of Ruben Covarrubias, but he was in the hospital checking on one of his pediatric patients when a nurse told him a baby "in distress" was being delivered. He cancelled his appointments and stayed to help with the delivery and post-delivery resuscitative efforts. The parents sued the hospital, their regular doctor and Kady. The court ruled that a doctor who renders emergency assistance to the patient of another doctor in the hospital is protected by the same law that shelters a doctor who stops to help an accident victim by the road.