Chemotherapy Administration Reciprocal Billing

LoriCox

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PLEASE HELP!

The Scenario: Dr. A is a Medical Oncologist. Patients present to the Cancer Center to receive their chemotherapy treatments. If Dr. A is present in the Cancer Center then we bill the chemotherapy administration under his NPI as he is providing direct supervision, even though he may not actually see the patient that day.

The Conflict: what to do when Dr. A is not in the Cancer Center?? Perhaps he is in another building or out of the country - either way he is not able to provide direct supervision.

Can we:
A. Send another physician or NPP to the Cancer Center to provide direct supervision. The claims would be billed under their own NPI.
B. Send another physician or NPP to the Cancer Center to provide direct supervision. The claims would be billed under Dr. A's NPI.
C. On the other side of the Cancer Center is a Radiation Department, NOT owned by Dr. A's clinic. Dr. B works for the Radiation Department as a Radiation Oncologist, he does not work for Dr. A's Center. He agrees to provide direct supervision everytime Dr. A is out of the office, which is at least once per week. However, he does not see the patients and at times is performing Radiation treatments on his other patients. Can we bill under Dr. A's NPI with the Q5 modifier, claiming Dr. B as our covering physician under a reciprocal agreement?

I am fighting my heart out on this and any, ANY, answers you can give me will be greatly appreciated!
 
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locums

Read the guidelines for Locum Tenens billing, that way you can bill under Dr. A with modifier "Q6". You'll need a locums contract,you can only do it for so long, and will have to check with each private payer how they want you to report it. That is the way I'd go.
 

LoriCox

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New London, MO
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Does the locum have to be from another facility or can he be a physician that works for the same company but in a different building? I have read the guidelines but either I am misreading or misunderstanding something in them.
 
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