Locum Tennens

DBoop87

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How does this work? Is it true that the claims can not be billed if both doctors are on premises, even if one doctor is not seeing patients? The doctor seeing patients is pending Medicare credentials so there is the use of modifier Q6. Also could you explain this modifier?

Thanks for any information you can provide.
 

LLovett

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Locum tenens is meant to provide coverage for a doctor that is out of the office due to sickness, vacation, etc, not to bill for uncredentialed providers.

It would not be correct to use the Q6 modifier and bill under the credentialed provider in your situation.

Q6 indicates this service was provided by another provider who was covering for the billing provider. So all the claims look exactly like they would if the regular physician was there but you add the Q6 to each cpt billed.

http://www.cms.hhs.gov/Transmittals/downloads/R1486CP.pdf

Hope this helps,

Laura, CPC
 

KKRAPFL

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Does 60 days mean 60 consecutive days or can it be 60 individual days over a 6 month time frame. We have a physician coming in that will work 1 week a month.
 

RebeccaWoodward*

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A “continuous period of covered visit services” begins with the first day on which the substitute physician provides covered visit services to Medicare Part B patients of the regular physician, and ends with the last day the substitute physician provides services to these patients before the regular physician returns to work. This period continues without interruption on days on which no covered visit services are provided to patients on behalf of the regular physician or are furnished by some other substitute physician on behalf of the regular physician. A new period of covered visit services can begin after the regular physician has returned to work.

EXAMPLE: The regular physician goes on vacation on June 30, and returns to work on September 4. A substitute physician provides services to Medicare Part B patients of the regular physician on July 2, and at various times thereafter, including August 30 and September 2. The continuous period of covered visit services begins on July 2 and runs through September 2, a period of 63 days. Since the September 2 services are furnished after the expiration of 60 days of the period, the regular physician is not entitled to bill and receive direct payment for them. The substitute physician must bill for these services in his/her own name. The regular physician may, however, bill and receive payment for the services that the substitute physician provides on his/her behalf in the period July 2 through August 30.

The requirements for the submission of claims under reciprocal billing arrangements are the same for assigned and unassigned claims.

30.2.10

http://www.cms.hhs.gov/manuals/downloads/clm104c01.pdf
 
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