Wiki Another filling in for another doc during the global period...

[Trendale]

Hello,

I need confirmation regarding a doctor filling in for another doctor during the patient's global period. I have a physcian that is trying to charge the patient because he said he was asked by the physcian who originally did the surgery, to see the patient on his behalf. It is a complication related to the surgery?
If you have any supporting links that will help a lot! Thanks!

 

[FTessaBartels]

Not sure I understand

Letisha - I'm not sure I understand the scenario ...

Dr Surgeon performs surgery. During post-op period Dr Surgeon ask Dr B to see the patient for a complication.

If this is correct and Dr B is not in Dr Surgeon's same practice, or is of a different specialty, then Dr B may have a consultation, or he may have an office visit (new or established).

-or-

Dr Surgeon performs surgery. During post-op period Dr Surgeon has to be out of office and asks Dr B to "cover for him." Dr B sees Dr Surgeon's patient during Dr Surgeon's absence.

No charge for Dr B, because he is, in effect, acting as Dr Surgeon. Dr B will be paid based on whatever arrangement he has with Dr Surgeon to act as locum tenens.

Hope that helps

F Tessa Bartels, CPC, CEMC

 

[Trendale]

reply Ftessa

Hello,

Yes that is what I was asking. Just one more thing to make sure I am clear. Both of these physcians are General surgeons (Dr A and DR B), However; they are not in the same practice, and do not work for the same hospital, So if doctor B is covering for Doctor A, Doctor B can charge a visit and no modifier will be appended? Also, do you know where I can find the guidelines on this?, just so I can give the practice something in writing.Thanks again!

 

[FTessaBartels]

Still not clear

Well, which scenario is it?

If it's the second one I outlined, Dr B is acting in locum tenens and should not be submitting charges to insurance at all. He is 'in effect' Dr A for the time period that he is covering. His payment arrangement for this coverage is a matter between the two physician practices.

F Tessa Bartels, CPC, CEMC