Primary Care Coding Alert

Question: One of our physicians will be away for eight weeks. She has made locum tenens arrangements for another physician to cover while she's away. There already is a nurse practitioner who bills incident-to under the regular physician. How do we bill the NP's services while the locum tenens physician is supervising?

California Subscriber

Answer: Incident-to requirements state that the supervising physician doesn't have to be the physician who is associated with the plan of service. Any physician can supervise, as long as the NP is acting as an extension of the plan created by a physician.

Documentation: For example, the NP is providing incident-to services based on Dr. A's plan. Dr. B is the locum tenens physician during Dr. A's absence. File the claim with Dr. A's name and identification numbers, with modifier Q6 (Service furnished by a locum tenens physician) to indicate a locum tenens physician was present instead of Dr. A. The supervising physician is the locum, but his name won't actually be included on the claim.

Caution: CMS has a 60-day time limit for using locum tenens physicians. If your physician will be gone longer than that, she should arrange for another physician to perform locum duties on her behalf after the 60-day mark.