GC - JF Part B
Modifier GC
Service has been performed in part by a resident under the direction of a teaching physician
Correct Use
- Append to service that has been completed by a resident in a teaching facility in part under direction and supervision of a teaching physician
- Medicare does not pay for any service furnished by a medical student as defined in CMS Internet Only Manual (IOM), Publication 100-04, Claims Processing Manual, Chapter 12, Section 100.
- Append in second modifier field when supervising/teaching anesthesiologist is involved in two concurrent anesthesia cases with one resident (or "fellow"), he/she may bill usual base units and anesthesia time for amount of time present with resident throughout pre, intra and post anesthesia care.
Incorrect Use
- Append to service when teaching physician is not involved with any part of care
Documentation
Notes recorded in the patient's medical records may be entered by a resident, teaching physician or nurse regarding the service furnished. Documentation may be dictated and typed or hand-written, or computer-generated and typed or handwritten. Documentation must be dated and include a legible signature or identity. Pursuant to 42 CFR 415.172 (b), documentation must identify, at a minimum, the service furnished, the participation of the teaching physician in providing the service, and whether the teaching physician was physically present.
Examples
- Acceptable
- Patient became hypoxic and hypotensive. I spent 45 minutes while the patient was in this condition, providing fluids, pressor drugs and oxygen. I reviewed the resident's assessment and plan of care.
- Unacceptable
- I saw the patient and agree with the resident.
Note: In a time based setting, such as critical care, time spent teaching does not count towards the critical care time of the physician; nor does the time the resident spent with the patient. Only time spent together with the patient or the teaching physician alone can be counted towards critical care time.
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