Thank you! That is what I was thinking but wanted to make sure before I billed it out.If you are coding and billing the professional services of the surgical procedure, then you'd need to bill it as it is documented. It shouldn't matter who is attending - you're coding for a particular service and need to represent accurately what was done in the procedure. That one or the other of the physicians is in the role of attending is not a factor in the coding of the procedure itself.
Thank you for this info! How to bill for fellows is always a confusing area for me!With fellows, it can get a bit trickier than with residents. While fellows are typically fully licensed physicians, if they are working for a GME approved fellowship, they are fall under the same exact guidelines as residents. In those situations, you follow the same billing guidelines as residents - attestations, etc.
However, sometimes fellows moonlight or are training in a NON GME approved fellowship. In those circumstances, they are a fully licensed physician and billable as such.
Here's my real life situation regarding fellows. At our gyn oncology practice, we sponsor a one year non-GME fellowship in complex pelvic surgery and minimally invasive procedures. It is designed for an ob/gyn who has already completed residency who wants to gain more surgical training than the typical ob/gyn program provides. Training is mostly by gyn oncology, but also touch into urogynecology. Most of our graduating fellows do not do much OB work, but rather become the expert surgeon for non OB cases in an ob/gyn practice. Since the fellow is in a NON GME program, their services are fully billable under their own credentials. If we started up a 3-4 year gyn oncology GME fellowship, those fellows would not be billable, unless working outside their fellowship.
Here is an old, but still relevant prior thread about it. https://www.aapc.com/discuss/threads/fellow-vs-resident.10087/
Would this also go for a resident if the resident is listed as the primary surgeon but the teaching physician is listed as the assist and the teaching physician has documented their attestation this is still billable correct?By my understanding, a fellow is a fully licensed physician, unlike a resident who one still in training. If you are coding and billing the professional services of the surgical procedure, then you'd need to bill it as it is documented. It shouldn't matter who is attending - you're coding for a particular service and need to represent accurately what was done in the procedure. That one or the other of the physicians is in the role of attending is not a factor in the coding of the procedure itself.
With fellows, it can get a bit trickier than with residents. While fellows are typically fully licensed physicians, if they are working for a GME approved fellowship, they are fall under the same exact guidelines as residents. In those situations, you follow the same billing guidelines as residents - attestations, etc.
However, sometimes fellows moonlight or are training in a NON GME approved fellowship. In those circumstances, they are a fully licensed physician and billable as such.
Here's my real life situation regarding fellows. At our gyn oncology practice, we sponsor a one year non-GME fellowship in complex pelvic surgery and minimally invasive procedures. It is designed for an ob/gyn who has already completed residency who wants to gain more surgical training than the typical ob/gyn program provides. Training is mostly by gyn oncology, but also touch into urogynecology. Most of our graduating fellows do not do much OB work, but rather become the expert surgeon for non OB cases in an ob/gyn practice. Since the fellow is in a NON GME program, their services are fully billable under their own credentials. If we started up a 3-4 year gyn oncology GME fellowship, those fellows would not be billable, unless working outside their fellowship.
Here is an old, but still relevant prior thread about it. https://www.aapc.com/discuss/threads/fellow-vs-resident.10087/
No, resident services performed as part of the teaching program are always billed under the attending physician's credentials, with the GC modifier. And teaching programs are not allowed to bill for an assistant at surgery unless a qualified resident is not available to assist. So whether the resident is acting as the surgeon or the assistant won't affect the billing of the claim - you'd bill the teaching physician as the surgeon and would not bill any charge for the assistant.Would this also go for a resident if the resident is listed as the primary surgeon but the teaching physician is listed as the assist and the teaching physician has documented their attestation this is still billable correct?