Orthopedic Coding Alert

Question: My orthopedic surgery group is using a locum tenens to fill in at the hospital while one of our surgeons is out, but we aren't sure how to bill it. How should I report these services?


New Mexico Subscriber

Answer: Append modifier Q6 (Service furnished by a locum tenens physician) whenever you code for a locum tenens physician who is working in the place of a full-time physician.

Modifier Q6 is one modifier you may not have to use too often, but it's one that has specific rules you need to know. For example, you can't use this modifier for services performed when the group employs extra physicians during peak times, but only when the locum physician is replacing a physician who is absent.

If your practice is short-staffed, engage the short-term doctors as contracted physicians rather than locum tenens, and use the personal provider number of the short-term doctor. You also shouldn't use Q6 to code for a new physician who's waiting for Medicare to activate his identification number.

Another rule to remember is that Medicare won't consider someone to be locum tenens if he works for more than 60 continuous days. If the physician will be working more than 60 continuous days--for example, during your orthopedic surgeon's maternity leave--don't use Q6.

Instead: Report services under the providing physician's identification number. However, if the physician takes a break and then resumes work, once again respecting the 60-day maximum, he should meet Medicare's requirements.