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locum tenens billing

  1. Question locum tenens billing
    Medical Coding Books
    "a physician who has left the group and for whom the group has engaged a locum tenens physician as a temporary replacement may still be considered a member of the group until a permanent replacement is obtained.
    The medical group physician for whom the substitute services are furnished must be identified by his NPI in Item 24j of the CMS-1500 or the electronic equivalent of the appropriate line item."

    question: how long can we bill for locum tenens under a md who left the group practice? the quote above only states "until a permanent replacement is obtained". can this go on for more than the 60 days frequently stated?

    also, how long can we use the npi from the md that left the group practice for the locum tenens? can we use it even when the md that left starts working for another practice?

  2. #2
    You can only use if for 60 days if they just left the practice.

    The only time extension is if they have been called to active duty. There are exceptions to this rule when this happens but it doesn't sound like this is your situation. It shouldn't matter if they start working elsewhere since you will be submitting your claims with the Q6 modifier which identifies it is not really them. Key word is "shouldn't", I have not personally had a problem but that doesn't mean it can't/won't happen on occasion.

    Laura, CPC, CEMC

  3. Default
    thank you - now i can send this to my boss

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