using the GC modifier with a "resident team"?
Got this issue today, never heard of this before...
If a resident or resident team is involved in the care you should assign the GC modifier to show participation in the residency teaching program. It does not matter if the resident wrote a note or if the teaching physician tied into the note. The teaching provider indicated that she discussed the case with the resident.
Thoughts?
Mary
Mary Flanery, CPC, CBCS, CHC
Quality Review Specialist
MedStar Physician Billing Services
Baltimore, Maryland 21220
MedStar Health is a not-for-profit, integrated healthcare delivery system, the largest in Maryland and the Washington, D.C., region. Nationally recognized for clinical quality in heart, orthopaedics, cancer and GI. IMPORTANT: This e-mail (including any attachments) may contain information that is private, confidential, or protected by attorney-client or other privilege. If you received this e-mail in error, please delete it from your system without copying it and notify sender by reply e-mail, so that our records can be corrected. Thank you. Help conserve valuable resources - only print this email if necessary.
If a resident or resident team is involved in the care you should assign the GC modifier to show participation in the residency teaching program. It does not matter if the resident wrote a note or if the teaching physician tied into the note. The teaching provider indicated that she discussed the case with the resident.
Thoughts?
Mary
Mary Flanery, CPC, CBCS, CHC
Quality Review Specialist
MedStar Physician Billing Services
Baltimore, Maryland 21220
MedStar Health is a not-for-profit, integrated healthcare delivery system, the largest in Maryland and the Washington, D.C., region. Nationally recognized for clinical quality in heart, orthopaedics, cancer and GI. IMPORTANT: This e-mail (including any attachments) may contain information that is private, confidential, or protected by attorney-client or other privilege. If you received this e-mail in error, please delete it from your system without copying it and notify sender by reply e-mail, so that our records can be corrected. Thank you. Help conserve valuable resources - only print this email if necessary.
Comments
1. A Resident was involved in providing the service
2. A teaching physician was supervising the service and was personally involved in the service
a. And that leads to the required teaching physician statement
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf
There is a primary care exception rule, but that’s using modifier GE.
Kris
Kris Cuddy, CPC, CIMC
Healthcare Compliance Analyst
Compliance Office
Michigan State University HealthTeam
East Lansing, MI
Ofc: 517-355-4547
Fax: 517-353-5292
Thanks
Deborah Broyles, CPC
Supervisor/Coding Specialist
University Radiation Oncology/University Surgical Oncology
865-305-9886 phone / 865-305-9714 Fax
From: Kristine Cuddy [mailto:Kristine.Cuddy@hc.msu.edu]
Sent: Monday, June 27, 2016 2:40 PM
To: Multiple recipients of list PARTB-L
Subject: RE:[partb-l] using the GC modifier with a "resident team"?
Oh my…that’s not good from my perspective. Modifier GC is to let the carrier know:
1. A Resident was involved in providing the service
2. A teaching physician was supervising the service and was personally involved in the service
a. And that leads to the required teaching physician statement
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf
There is a primary care exception rule, but that’s using modifier GE.
Kris
Kris Cuddy, CPC, CIMC
Healthcare Compliance Analyst
Compliance Office
Michigan State University HealthTeam
East Lansing, MI
Ofc: 517-355-4547
Fax: 517-353-5292
Kris
Kris Cuddy, CPC, CIMC
Healthcare Compliance Analyst
Compliance Office
Michigan State University HealthTeam
East Lansing, MI
Ofc: 517-355-4547
Fax: 517-353-5292
So you believe that a resident does NOT have to document anything…
Kris
Kris Cuddy, CPC, CIMC
Healthcare Compliance Analyst
Compliance Office
Michigan State University HealthTeam
East Lansing, MI
Ofc: 517-355-4547
Fax: 517-353-5292
That seems to be the confusing point here.
Thank you