ED Coding & Reimbursement Alert - 2017 Issue 1
Bust Locum Tenens Myths To Stay On Track
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Article Overview
This article explains the main compliance and billing topics surrounding locum tenens physician coverage. It is aimed at medical practice staff, coders, and billers who need a general understanding of temporary physician substitution, applicable Medicare-related timing concepts, and the modifiers associated with this type of billing. The piece also addresses common misconceptions about who can be covered, how the arrangement is structured, and how the billing relationship is represented.
Why This Topic Matters
Locum tenens billing can affect claim accuracy, audit readiness, and compliance with payer expectations. Understanding the general framework helps practices avoid common administrative mistakes when a physician is temporarily unavailable.
Article Sections
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Know the ABCs of LT
Introduces the concept of locum tenens and explains the general purpose of temporary physician coverage in a practice setting.
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Myth #1: You can bill LT for non-physicians.
Addresses the scope of locum tenens coverage and the types of practitioners discussed in the article.
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Myth #2: It’s acceptable to neglect the time limit for LT.
Reviews the timing concepts tied to locum tenens coverage and mentions a Medicare-related exception discussed in the article.
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Myth #3: Practices can hire an LT as “extra help.”
Covers the contractual nature of the arrangement and how the article characterizes the role of the temporary provider.
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Myth #4: The modifiers are optional.
Focuses on billing identifiers associated with locum tenens services and related compliance cautions.
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Billing scenario solution
Summarizes the example scenario and the general billing arrangement described for temporary physician coverage.
What You Will Learn
- The general purpose of locum tenens coverage in medical practices
- Common misconceptions about temporary physician substitution
- Timing and compliance considerations discussed for locum tenens arrangements
- How the article frames the billing relationship for temporary physician coverage
- Which modifier-related topics are associated with locum tenens billing
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Compliance staff
- Physician office staff
Modifiers Discussed
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