Wiki How to code when doc is on vacation

[Orthocoderpgu]

We have a doc covering for another doc who is on vacation. Both docs belong to the same group, same specialty. The office manager wants to bill the charges using the vacationing docs name, I'm not so sure. Does anyone know or can point me to documentation either way? Thanks for your help.

 

[mcnaryk]

We have a doc covering for another doc who is on vacation. Both docs belong to the same group, same specialty. The office manager wants to bill the charges using the vacationing docs name, I'm not so sure. Does anyone know or can point me to documentation either way? Thanks for your help.

I am guessing your office manager wants to use the vacationing doc's name for reporting purposes, but since they work for the same group, same specialty, I don't think modifier Q5 (reciprocal billing) would apply in this case. Q5 is usually when a provider from a different group/specialty agrees to see vacationing doc's patients, and Q6 (locum tenens) is a doctor who usually has no practice of their own, they are just hired to cover the vacation or other leave of absence. You would have to bill the charges under the doctor who is performing the services name/number. If your manager is worried about reports, maybe they could run a report for the dates in question, and sort by PCP if your system has that ability.

 

[mitchellde]

You cannot use a provider NPI that is not in the office at the time of the visit. 24J is for rendering/supervising provider , if the provider is out of the office he can be neither rendering nor supervising