This posting is directed at those of you who work at training centers
in the United States:

A CUMG compliance officer recently advised our group that in order to bill
for any procedure, regardless of the length of time it takes to perform,
the attending must be present during the "important" part of the
procedure. Therefore, to bill for an LP you must be present during the
needle insertion, to bill for suturing you must see at least some of the
sutures go in, to bill for a splint you must be present, etc.  The
attending must also document their presence or assistance.

For those of you at American teaching institutions, do you bill for
procedures performed by the residents, loosely supervised by you (e.g..
you go in if the resident doesn't reappear with CSF within a few minutes,
or you check the sutures after they are done) but where you aren't
actually in the room for the procedure?

Does anyone have additional insight on this matter to advise us further?


Julie Brown, MD
Pediatric Emergency Medicine Fellow, box CH-04
Children's Hospital and Regional Medical Center
Seattle, WA 98105
e-mail: [log in to unmask]
fax: 206 527 3892

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