Wiki Resident in the ER

[carolbuchmann]

Please clarify--
The resident in the ER reduces a fracture after consulting BY PHONE with the ortho surgeon on call.
The surgeon does not see the patient. Private insurance (not MCR).
The surgeon cannot bill anything-- correct?
The patient's follow up visit to the office- new patient? Post operative care only?
Thanks,
Carol

 

[FTessaBartels]

Commercial payers

Most commercial payers only require that the supervising physician be available by any modern means of communication. So, yes if the resident has conferred with the teaching physician via phone about the case and documents that s/he has spoken to the TP and that the TP concurs with the diagnosis, and plan of care, then you can bill the resident's services under the TP name.

Again... this may vary with payer.

If you wind up billing out fracture care for the resident's services, then any clinic follow-up will be considered part of the global package.

If you do NOT bill out the resident's care, then the first visit in the clinic will be a new patient.

Hope that helps.

F Tessa Bartels, CPC, CEMC