Resolved Billing global care when Locum Tenens performs delivery

[RebeccaH_6813]

Hello,
Our OB clinic will be utilizing a Locum Tenens to cover for one of our physicians for less than 60 days. If the Locum Tenens performs a delivery are we still able to bill for the global package?
Also, do we list the Locum Tenens as the Rendering Provider NPI in box 24j on the 1500 form?
Thank you for your help!

 

[Alicia]

I asked a Peer about this, Don Self. This is what he stated.

LT is a Medicare Rule and is only applicable to Medicare. How many OB patients have Medicare? For billing relating to Medicaid or commercial payers, you’ll need to validate with the individual payers if they have adopted the Medicare rule, and if not, understand the specific rules that govern their reimbursement of locum tenens providers. Some will use LT rules and some will not.

If a carrier does use Medicare's rule, you won't use the name of the substitute physician. Claims must contain the NPI of the regular physician and not the locum or substitute physician. This is entered in CMS-1500 claim in block 24J.

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[RebeccaH_6813]

Thank you so very much, I really appreciate this information!