Neurosurgery Coding Alert

Question: One of the neurosurgeons in our group is expecting a baby, so she will be taking maternity leave. Until this neurosurgeon returns from maternity leave, our practice will turn her patient load over to a locum tenens (LT) physician. Is there a certain modifier we should append to the LT services?

California Subscriber

Answer: Yes. You must append modifier Q6 (Service furnished under a fee-for-time compensation arrangement by a substitute physician; or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area) to any code for services the locum tenens provides.

Locum tenens defined: In the medical field, you can bring in a LT physician to temporarily replace another physician who cannot be in the office for some reason such as vacation, illness, or maternity leave.

When you bill a LT physician’s services, you bill them under the physician he is replacing for that time period. Modifier Q6 tells the payer that the LT physician is practicing medicine on behalf of the original physician, who is not available to see patients. This also indicates that the situation is temporary. The modifier protects your physician in the event of an audit, because obviously your original physician didn’t perform those services - the locum did.  

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