Wiki Teaching Physician Rules??

[keke74]

Hello everyone,

I have a couple of questions in regards to the teaching physician rules. If a foley catheter is placed by nursing staff as ordered by resident but the teaching physician did not directly supervise the procedure, can you still pick up the procedure? The teaching physician does document that he participated in the services rendered to the patient. Do the rules apply to procedures performed by the nursing staff also as far as direct supervision goes?

Another scenario. The physician specifically stated he was not present for the procedure performed by the resident but the patient was to follow up with him in 1 week. I didn't think I should have picked up the procedure but I was told by an auditor that since the physician stated the patient was to follow up with him in 1 week that it was ok to pick up the procedure.

Please share your thoughts on the above scenarios.

Thanks in advance

 

[jimbo1231]

Don't Think So

I think both scenarios are problematic in a teaching setting.

Foley Foleys are viewed as a Nurse procedure even by the most aggressive ED companies unless the physician actually placed the Foley which is rare.

Next Week Particularly in an ED setting this scenario wouldn't fly. You are coding for the services rendered in the teaching setting for that encounter, not next week. Only thing I think you can do with plan to see the patient next week in count it toward MDM if all other teaching elements were documented..

Jim S.