ED Coding & Reimbursement Alert - 2010 Issue 27
Reader Questions: Clarify Temp Services Using Modifier Q6
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Article Overview
This short coding Q&A addresses how substitute physician services are represented on a claim, with emphasis on Medicare-related locum tenens reporting. It is aimed at billing staff, coders, and physician practices that need a high-level understanding of when a substitute provider is involved and how the claim is generally structured. The article also includes a brief example involving an evaluation and management office visit.
Why This Topic Matters
Temporary coverage arrangements can affect how services are reported and who the claim is billed under. Understanding the relevant modifier and the broad billing context helps practices avoid preventable claim-processing issues.
What You Will Learn
- How substitute physician services are identified in billing contexts
- The general Medicare-related topic of locum tenens reporting
- How a brief example illustrates claim presentation for a temporary provider scenario
- The relationship between a substitute physician arrangement and office visit billing
Who Should Read This
- Medical coders
- Billing staff
- Physician practice managers
- Compliance staff
Codes Discussed
Modifiers Discussed
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