Pulmonology Coding Alert

Question: When you report locum tenens (stand-in physician) services,should you add modifier Q5 (Service furnished by a substitute physician under a reciprocal billing arrangement) to the report? Ohio Subscriber Answer: When you report locum tenens services, dont confuse modifier Q6 (Service furnished by a locum tenens physician) with reciprocal billing modifier Q5. Reciprocal billing arrangements typically describe a two-way exchange between providers. For example, your pulmonologist and another pulmonologist agree to see each others patients on alternating weekends and agree to a reciprocal billing agreement. These services would fall under modifier Q5. In these situations, the doctor who owns the patients, not necessarily the one who saw them at those visits, bills out the provided services under his national provider identifier (NPI) and appends modifier Q5 to indicate he really did not see the patient. The physicians dont exchange any money because the services should even out over time. By [...]