We have an EP specialist that sees patients in our office once a month. We are in a rural community. We bill those visits with our Primary Cardiologist as the supervising and rendering provider. Notes are dictated and signed by the visiting physician. This started before I started coding visits.
I asked our Office Manager, at the time I had to start coding, if this was ok and was told it is in a "gray area, kindof like a locum". I am very uncomfortable with this practice. My gut tells me it is wrong. We are contracted with Medicare, a lot of these patients are of Medicare age. The visiting physician has a practice within the state and has a valid NPI and is credentialed with Medicare and other commercial payers through it.
We do pay this physician a per diem rate for seeing patients, but I cannot find some concrete specific language that I can take to my new practice manager to argue my case. I do have the language on Locums and this situation does not fit that criteria, as he is not covering for an absent physician,it has been over 60 consecutive days, and the Q6 orQ5 modifiers are not being used.
Any help or direction would be appreciated.
I asked our Office Manager, at the time I had to start coding, if this was ok and was told it is in a "gray area, kindof like a locum". I am very uncomfortable with this practice. My gut tells me it is wrong. We are contracted with Medicare, a lot of these patients are of Medicare age. The visiting physician has a practice within the state and has a valid NPI and is credentialed with Medicare and other commercial payers through it.
We do pay this physician a per diem rate for seeing patients, but I cannot find some concrete specific language that I can take to my new practice manager to argue my case. I do have the language on Locums and this situation does not fit that criteria, as he is not covering for an absent physician,it has been over 60 consecutive days, and the Q6 orQ5 modifiers are not being used.
Any help or direction would be appreciated.