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On Fri, 29 Nov 1996, Martin Herman wrote [in part]:
 
> -- [ From: Martin Herman * EMC.Ver #2.5.1 ] --
>
> Regarding the resident coverage and the attendings seeing the patients..
> One also must remember that the regs clearly say that an attending can
> not bill for a service ,if the resident is capable of performing said
> service unsurpervised, even if the attending is standing at the bedside
> or repeats some of the service ( ie does his own exam)
 
Martin -
 
I think you may have mis-interpreted the rules. HCFA says that the
teaching physician may only bill for the level of service provided by the
teaching physician. If the resident sees the patient, the teaching
physician must document the *key* portions of the history, physical and
decision making on the chart, and confirm the remainder of the residents
H&P. To be able to bill for a procedure, such as an LP, the teaching
physician must be "present" for the procedure (HCFA does not define
physical presence). If the resident documents that the teaching physician
observed the resident's work (taking the H&P etc) then the teaching
physician only has only confirm the key elements of the H&P and decision
making and confirm his/her presence.
 
It doesn't matter whether the resident is "capable" of doing the work
involved as to the teaching physicians ability to bill or not... it is the
level of work documented by the teaching physician that you are allowed to
bill for. ACEP recently issued some guidelines clarifing this issue.
 
Jeff
 
 
Jeff Linzer MD MICP
Division of Emergency Medicine
Egleston and Hughes Spalding Children's Hospitals
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