Wiki Locum Coding Question

[danielawhit]

Is anyone else having problems with their locum claims being denied? The lady who works my claims says we are getting denials because the Locum doctor doesn't document who he is filling in for but I cannot find anything saying that they must document that? We are appending the modifier Q6.

 

[jdibble]

Is anyone else having problems with their locum claims being denied? The lady who works my claims says we are getting denials because the Locum doctor doesn't document who he is filling in for but I cannot find anything saying that they must document that? We are appending the modifier Q6.

I have never sent the claims out personally, but we did need to know whom the doctor was covering. I believe the doctor who the locum is filling in for needs to be on the claim (in the referring doctor box maybe). Are the claims going out with the other doctors name? If he isn't documenting who he is covering for, then maybe whoever sends the claims out is not putting in that information either.

If someone with more knowledge on this could give more information that would be great!

 

[danielawhit]

Thank you for your responce!

We are billing it under the doctor that they are filling in for's number with a Q6 modifier attached to the CPT code. I have the schedule to know who they are filling in for but of course the insurance company wouldn't know the schedule.