You Be the Coder:
Medical Student Coverage
Published on Fri Jun 01, 2001
Question: We rotate medical students through our rehabilitation center each week, because we are affiliated with a large university. When a medical student does the HPI or discharge summary for a patient, does the supervising doctor have to do anything more than cosign the note in order to bill?
Nevada Subscriber
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
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Answer: Medicare does not allow billing for services provided and documented by medical students who are working unsupervised. Physicians who allow students to perform services and later sign off on the documentation could find themselves in serious trouble should the OIG investigate their practices.
When students are accompanying the rehabilitation facilitys attending physician, the doctor must retain documentation proving that he or she was there with the medical student. The student may act as scribe documenting the physicians findings but if audited, this could imply that the supervising physician was not performing his or her own documentation, so they must be certain to prove their presence during an exam or procedure.
The Association of American Medical Colleges reported in Memorandum 95-68 that when a resident (or fellow) participates in a service furnished in a teaching setting, a Part B payment will be allowed only if the teaching physician is present to perform, or observe the resident perform, the key portion of any service or procedure. The key portion for a visit or consultation service is defined in CPT Codes as including the activities of history, physical exam and medical decision-making, and the key portion for a surgical or diagnostic procedure is self-defined by the physician.
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