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Radiology Coding Alert

Reader Questions:

Link Modifier Q6 to Locum Tenens Claims

Published on Mon Jan 11, 2010

Question: We hired a locum tenens for over the holidays. Do we code the same for the replacement physician as for a full-time radiologist?  Georgia Subscriber  Answer: Private payer rules may vary, but for Medicare patients, you should append modifier Q6 (Service furnished by a locum tenens physician) to all the temporary doctor's Medicare claims and bill under the national provider identifier (NPI) of the physician the locum is replacing.  You must append this modifier to every procedure code on a Medicare claim for a substitute physician. You'll send the bill out under the regular physician's name, but modifier Q6 alerts Medicare that a locum tenens physician provided the services.  Watch for: Medicare has a 60-day limit for a locum tenens physician, and your practice may not extend this, according to Medicare Claims Processing Manual, Chapter 1, Section 30.2.11, where you'll find additional details (www.cms.hhs.gov/manuals/downloads/clm104c01.pdf). Medicare does allow physicians to cover for absences of longer than 60 days by hiring multiple substitute physicians, each one to cover only the maximum allowable period of 60 days.  Private payers vary: Before using modifier Q6 for a non-Medicare patient, check with the commercial carrier. Some will follow the Medicare locum tenens guidelines, but you should not assume that all commercial carriers will want modifier Q6. Private payers' rules regarding substitute physicians can differ from Medicare's.  Definition: Locum tenens describes a one-way exchange between physicians, in which your radiologist retains a substitute physician to take over the practice temporarily and pays the substitute physician a fixed amount per diem. Reasons for bringing in a substitute may include illness, pregnancy, vacation, or continuing medical education. 

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