tci Medicare Compliance & Reimbursement - 2012 Issue 12
Reimbursement: Don't Bill CRNA Locum Tenens With Q6
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Article Overview
This Q&A-style article explains general locum tenens billing concepts for practices managing temporary physician coverage. It focuses on Medicare-oriented reimbursement guidance, claim preparation, and how locum tenens policies may differ by payer, with special attention to anesthesiology-related coverage scenarios. The piece is aimed at coders, billers, and practice staff who handle physician substitution claims and need a high-level understanding of the rules and administrative steps involved.
Why This Topic Matters
Locum tenens claims can be denied or misreported if the temporary coverage arrangement is not documented and billed correctly. Understanding the general framework helps practices support continuity of care while avoiding common reimbursement and submission errors.
Article Sections
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What Does "Locum Tenens" Mean?
Defines the general concept of locum tenens and describes the temporary coverage context discussed in the article. It also notes a Medicare time limit for this type of arrangement.
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How Do We Code for Locum Tenens Service?
Covers the billing and claim-format topics associated with locum tenens services. The section addresses payer-facing reporting considerations, Medicare-related guidance, and the need to check policies before submission.
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How Should We Report Multiple Providers?
Discusses situations where more than one substitute clinician is used during a coverage period. It focuses on documentation and administrative handling of multiple temporary providers in the locum tenens setting.
What You Will Learn
- The general meaning of locum tenens in medical practice
- How temporary coverage claims are presented at a high level
- Why payer policy review matters for locum tenens billing
- How multiple substitute clinicians may be tracked administratively
- What kinds of documentation support locum tenens arrangements
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Revenue cycle staff
- Anesthesiology office staff
Codes Discussed
Modifiers Discussed
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