-- [ From: Martin Herman * EMC.Ver #2.5.1 ] --
Okay, I yield.. Now answer this,, does the statement." present to
perform or observe" extend to mean being present in the immediate
vicinity if a problem arises?FOR EXAMPLE, SAY YOUR ARE THE ATTENDING..
The ED is cranking.. you discuss a patient with the intern/resident, go
see the patient and then the resident goes to perform the sepsis workup
but you as the attending have to see another patient,can you bill for
the residents LP or suprapubic tap?Or do you have to be at the
patients/residents side during the procedure to be able to bill for that
? Currently I do not bill for the LP/ suprapubic if I was not physically
in the room, nor do I bill for any suturing done by the suture techs
unless I am in the room and guiding the work. Now I do bill an E/M
service for my exam and I document my exam and history to the extent
required for that level of service. I read over the residents note but
do not editorialize. I choose instead to write my own, What are you
doing? Rewriting a H&P or making editorial comments?
How do others feel about the term , "present for the major portion of
the service", in the room at the time of the service or just in the
department available for assistance if needed?
One porblem I have with our interpreting this material is that until it
stands the test of fire,ie HCFA inquisition,we are operating in the dark
... I am told the risk exists that you can be held responsible
retroactively for past actions.SO, if your interpretation is too loose,
or the ACEP translation is too loose, could we be dinged???..
Always willing to listen,,,,
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