ED Coding and Reimbursement Alert

Question: One of the ED physicians at our practice is taking some time off, and a temporary physician will take her place while she's gone. What code should I use to indicate that certain services were performed by the substitute physician?

Answer: The general rule, particularly for Medicare and private payers that follow Medicare payment guidelines, is to use modifier Q6 (Service furnished by a locum tenens physician) when billing for substitute, or locum tenens, physicians. Locum tenens reporting guidelines govern all services provided to Medicare patients by a substitute physician. The modifier simply tells the payer that a locum tenens physician provided the services - a one-way exchange between physicians.

Rule of thumb: You must append modifier Q6 to every procedure code on a claim for a substitute physician. But remember, you should still send the bill out under the regular physician's name.