On Wed, 4 Dec 1996, Tom Terndrup wrote [in part]:
> The Association of American Medical Colleges issued a memorandum
> (October 25, 1996), clarifying the Medicare Teaching Physician
> Requirements for post-graduate year of the resident.
> "The final rule states that if the teaching physician is present to
> perform or observe the resident perform the key portion of a surgical
> procedure, the teaching physician may bill a Part B fee for that
> procedure, regardless of the post-graduate year of the resident."
All my resources from AAMC, ACEP, the University and HCFA all agree with
above. It doesn't matter whether the resident is "capable" of acting
independently or not. What matters in the amount of work and documentation
done by the teaching attending.
Now, Martin may be thinking about the "continuity clinic" exeption which
allows residents, after their first 6 months of training, to see a patient
without the teaching attending, but still allows the attending to bill for
office codes 99211-13. This exeption does not extent to the ED or urgent
Jeff Linzer MD MICP
Division of Emergency Medicine
Egleston and Hughes Spalding Children's Hospitals
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