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covering physician

  1. #1
    Default covering physician
    Medical Coding Books
    Our Dr. will be out of town for the holidays and has asked a Dr. from another group to cover for him. Does the covering physician charge our established patients as if they are established, or can he charge them as new?

    Thanks,
    Kelly Kletz, CPC
    Bloomington, IL

  2. #2
    Default
    Who's Tax ID are the claims being submitted under, yours or his? If yours, then the patients are established.

  3. #3
    Default
    Based on CPT E/M service guidelines, they should be classified the same way your provider would have had they been the one to see them.

    Laura, CPC, CEMC

  4. #4
    Default
    Yeah I read that in the CPT book but that just doesn't sound right. If it is another Dr. from a completely different practice that you are covering for I would still think you would be able to bill a new patient.
    Herbie W Lorona Jr., CPC, CPC-H
    hlorona@up2parmedicalclinic.com

  5. #5
    Default
    ^^ No, not really. The higher reimbursement for new patient visits is because of all the background work that the physician's staff must do such as getting records from other medical providers, getting past test results, etc. All that stuff has already been done and is part of the patients chart already, so they shouldn't get paid for doing all that again, when they don't have to.

  6. #6
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by Walker22 View Post
    ^^ No, not really. The higher reimbursement for new patient visits is because of all the background work that the physician's staff must do such as getting records from other medical providers, getting past test results, etc. All that stuff has already been done and is part of the patients chart already, so they shouldn't get paid for doing all that again, when they don't have to.
    Agree....

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