General Surgery Coding Alert - 2006 Issue 11
Double-Check for Modifier Q6 on Your Locum Tenens Claims
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Article Overview
This article covers Medicare claim handling for locum tenens physician coverage in an emergency department setting. It is aimed at coders, billing staff, and practice administrators who need a clear overview of the documentation and billing steps associated with substitute physician services, along with notes about how private payers may differ in their requirements.
Why This Topic Matters
Locum tenens arrangements can affect whether claims are accepted and paid, so billing teams need to understand the general Medicare process and related payer considerations before submitting claims.
Article Sections
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You Can't Hire Locum Tenens Doctor as Extra Staff
This section outlines the situations in which a substitute physician may be used and clarifies the general role of the replacement physician in the practice setting.
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Remember Q6 on All Locum Tenens Claims
This section discusses Medicare claim handling for substitute physician services, including documentation, reporting, and how example services are presented in the article.
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Observe 2-Month Limit for Substitute Doctors
This section addresses time limits for locum tenens coverage and notes that payer requirements may vary outside Medicare.
What You Will Learn
- How the article frames locum tenens coverage in a practice or emergency department setting
- What general Medicare claim-processing topics are associated with substitute physician services
- Why payer verification matters when locum tenens services are billed to non-Medicare insurers
- What kinds of administrative questions practices may need to ask about temporary physician coverage
Who Should Read This
- Medical coders
- Billing staff
- Practice administrators
- Revenue cycle professionals
- Emergency department billing teams
Codes Discussed
Modifiers Discussed
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